David Dennis, MD
What first brought you to NASS, and what do you remember about the early years?
I had the privilege of being a fellow of Dr. Leon Wiltse in Long Beach, California in 1979. During my fellowship we had discussed forming an association dedicated to care and treatment of the spine. He introduced me to many of the other pioneers in spine surgery. He called me and told me that they were finally getting together for the first meeting in Colorado and asked me to attend. The group was very small at first and there were no breakout groups. It was the first time any medical group had allowed chiropractors to attend as well PTs. The purpose to have a broad multidisciplinary discussion about spine care not just surgery. There were great debates between the never surgery always rehab physicians and the always surgery therapy doesn’t work group.
Can you share your favorite NASS memory?
The family events the first few years.
What was spine care like when you entered the field and how did it evolve throughout your career?
When I started I would see patients that had residual pantopaque dye in their spines from old myelograms. We had to do myelograms on almost everyone now only rarely. We still had to do epidural venograms to help define the disc. Cat scans were just starting in 1979 and of course the MRI changed everything. In the 1980s a dark disc or degenerative disc was not considered pathological and surgery to treat this could result in a peer review. An artificial disc was not even a remote fantasy much less a robot or navigation.
Who were some of the people who shaped your experience in NASS?
Leon Wiltse, Vert Mooney, David Shelby,
What did it feel like to be a part of building NASS into what it is today?
It’s great to see spine take its place as one of the leading and busiest disciplines of orthopedics.
Looking back, what was one of the biggest challenges the spine field faced during your active years, and how was it addressed?
The class action lawsuit against surgeons for use of pedicure screws was my worst nightmare. I don’t really remember how it was all resolved without payment.
If you could preserve one lesson or philosophy for future generations of spine care providers, what would it be?
Treat the patient as you would yourself or family.
What did you learn from patients that changed how you approached your work or saw your role in the field?
Everyone handles pain differently. Not everyone with a neurological deficit needs an operation.
What does "service to the profession" mean to you, and how did you try to live that out?
By giving the best advice available based on scientific evidence.
What do you see as the most important challenge or opportunity facing the future of spine care?
Cost and access to well trained surgeons. Nurses and PAs are no substitute.
What emerging innovations do you think will have the most impact on patient care?
AI will be able to diagnose and read an X-ray probably better than an MD. I think a time will come when AI, navigation and robotics merge to do a complete operation.
If you were entering the field today, what area would you be most excited to pursue?
Genetic engineering to improve body tissue to prevent or improve damage to the spine.
In your view, what role should professional societies like NASS play in shaping the future of medicine?
It must take a key role since there is so much push back against science.
What's one hope you have for the spine community 40 years from now?
That it has succeeded in eliminating back pain or curing it.
What would you most like to be remembered for in your career?
That I cared for my patients.
If someone finds your message in this time capsule decades from now, what would you want them to know about the people who built NASS?
That they were dedicated, scientific, driven. That they cared about patients and wanted the best outcomes. They were open minded to all potential treatments.
What has being part of NASS meant to you personally?
A chance to discuss and share thoughts on easy and mostly on difficult cases.
What do you believe is NASS' greatest legacy to the field, and what do you hope future members carry forward?
It approached spine care with a rigorous academic standard.
If someone in 2065 is reading this and just starting their career in spine, what do you want them to know?
That treatment of spine patients is based on subjective complaints. A spine surgeon has to listen and be a part time psychiatrist and counselor.