Scott Tromanhauser, MD, MBA

What first brought you to NASS, and what do you remember about the early years?

I started my career in spine surgery at a time when technology and new implant development was exploding in the field. NASS was the place to be and interact with the giants in our field, like Hansen Yuan, John Kostuik, Henry Bohlman, Tom Zdeblick, to name just a few.

Can you share your favorite NASS memory?

Too many to name! Some were during the meeting itself but many were after hours with friends. I specifically remember being at a sports bar in downtown Chicago with a large group of colleagues from Boston, all watching the Red Sox playing against the Cardinals in the third game of the 2004 World Series. They won the game and our entire group got quite exuberant shall we say. Three Chicago police cars pulled up out front and we were politely asked to leave. Of course, Boston went on to win the next game as well and the Series for the first time since 1918.

What was spine care like when you entered the field and how did it evolve throughout your career?

Fusions without instrumentation. Lots of anterior and posterior iliac crest bone graft harvesting. Crudely designed implants and insertion tools. We often used surgical instruments design for very different uses. Not unlike using pliers to tighten nuts. I and my colleagues were all involved in early FDA trials of threaded cages, BMP, lumbar and cervical disc replacements. Much easier to enroll patients in these studies until the payers caught on and decided not to cover these types of procedures.

Was there a particular project, committee, or initiative you were proud to be a part of? What made it memorable?

I was allowed to organize and lead a symposium on chronic pain and was awarded a NASS Clinical Traveling Fellowship in 1996, where I spent time with Tom Zdeblick, Scott Boden, and Hal Mathews.

Who were some of the people who shaped your experience in NASS?

Tom Zdeblick and Hansen Yuan. Consummate gentlemen, educators and mentors.

What did it feel like to be a part of building NASS into what it is today?

I never failed to feel inspired after every meeting. There was always much new to learn, but I also had my own approaches and thinking confirmed.

Looking back, what was one of the biggest challenges the spine field faced during your active years, and how was it addressed?

In the early 90s, there was a lot of legal challenges to the use of pedicle screws. I remember being deposed by five different legal teams at once over an old fashion telephone conference call.

If you could preserve one lesson or philosophy for future generations of spine care providers, what would it be?

Be very skeptical of any and every shiny new thing that comes along. Ask for evidence of clinical effectiveness and be aware of the costs. So much technology has come and gone with lots of promotion and promise but ultimately failing to deliver.

What did you learn from patients that changed how you approached your work or saw your role in the field?

I learned to ask them what the problem was that they wanted me to solve. Only then could I be honest about the ability to solve that problem. Not everything can be fixed with surgery.

What does "service to the profession" mean to you, and how did you try to live that out?

I tried to be intellectually honest, conservative in my treatment approaches but open to new developments. I contributed to medical student, resident and fellow education and training, and was consistently involved in clinical research.

What do you see as the most important challenge or opportunity facing the future of spine care?

I see the need to resolve the issue of the need for spinal fusion along with laminectomy. There’s precious little evidence to suggest fusion is needed in most cases yet it is commonly done.

What emerging innovations do you think will have the most impact on patient care?

I’ve been a longtime advocate for the application of artificial intelligence in treatment decision-making. Many of our patients have chronic pain and our treatments are not as effective as we think in these situations. The patients and the problems are complex, a situation that lends itself well to analysis with AI. Avoiding surgery that has little chance of success is crucial.

If you were entering the field today, what area would you be most excited to pursue?

Surgical treatment for debilitating adult deformity. I saw this evolve tremendously over my career and didn’t feel adequately trained to treat these patients. If I were starting over, I would focus here.

In your view, what role should professional societies like NASS play in shaping the future of medicine?

Demand providers be accountable for their results. Make collection of patient-reported outcomes and costs an important part of membership, then celebrate those that do. Interact more with payers and be a part of solving the scourge of prior authorization.

What's one hope you have for the spine community 40 years from now?

Better results and less unnecessary interventions,

What would you most like to be remembered for in your career?

To be the first to introduce the use of artificial intelligence, then referred to as neural networks, to spine care. Presented on this subject at NASS in 2001,