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Today’s Abstract Sessions: Precision, Prediction, and the Future of Spine Surgery

Debuting Today: Research and Mentorship Showcase

The final day of the NASS Annual Meeting brings three high-powered abstract sessions exploring how personalization, prediction, and technology are shaping the next era of spine care. From biomechanics and biologics to advanced imaging and machine learning, presenters will share data-driven insights on improving outcomes and minimizing complications across complex cases..

7:00-8:00 AM MST

Personalized Strategies in Spine Care
Moderators: Alan S. Hilibrand, MD; Choll W. Kim, MD, PhD; Morteza Sadeh, MD, PhD

8:00-9:30 AM MST

Predicting Outcomes and Preventing Complications in Spine Surgery
Moderators: Nathaniel Brooks, MD; Brandon Lucke-Wold, MD, PhD, MHS

11:00 AM–1:00 PM MST

Research and Mentorship Showcase
Moderators: Neel Anand, MD; Sigurd H. Berven, MD; Christopher M. Bono, MD; Michael G. Fehlings, MD, PhD, FRCSC; Fred H. Geisler, MD, PhD; Jack Jallo, Choll W. Kim, MD, PhD; Thomas M. Mauri, MD; Richard J. Nasca, MD; Gil Tepper, MD

Celebrate research and community in spine care during this new showcase event. Enjoy brunch and RapidFire presentations from invited scholars spanning surgical innovation, biomechanics, and practice development alongside conversations on mentorship, career transitions, and lifelong learning.

Each session offers concise presentations and lively discussion, translating evidence and experience into actionable insights for every stage of a spine career.

Can’t attend in person? Recordings of these and other Annual Meeting sessions will be available after the meeting through the all-new NASS Anytime. Subscribers can stream on-demand content at their convenience and stay current on the latest research and discussions. Subscribers can stream on-demand content at their convenience and stay current on the latest research and discussions. Subscribe at: nassanytime.spine.org

Saturday Symposium Highlight: Medicare’s TEAM - Managing Spinal Fusion Under a Mandatory Bundled Payment Model

We are pleased to spotlight insights from Brook Martin, one of the session moderators for “Medicare’s Transforming Episode Accountability Model: Managing Spinal Fusion Under a Mandatory Bundled Payment Model,” which takes place at 3:30-5:00 PM today. The session will unpack one of the most consequential policy shifts facing spine care in 2026. In this Q&A, he outlines what TEAM changes, why it matters, and how surgeons and hospitals can prepare.

1. The Transforming Episode Accountability Model (TEAM) initiative represents a major shift in how Medicare reimburses spinal fusion. What are the key elements of this model that spine providers need to understand before it takes effect in 2026?
As of August 2025, a total of 716 hospitals were randomly selected to participate in TEAM upon its launch on January 1, 2026, along with an additional 10 voluntary participant hospitals. Many of the included hospitals currently have episode costs that are much higher their regional average costs, suggesting significant financial pressures.

TEAM includes 11 heterogeneous categories of inpatient and hospital outpatient fusions, including both cervical and lumber fusions as a 30-day episode of care with a regionally-based (U.S. Census Division) price target.

Hospitals can receive payment adjustments for quality, but the quality measures are system wide, as opposed to spine-specific. Nevertheless, “success” in the fusion bundled episodes will likely depend on mitigating 30-day complications, which can be difficult to predict.
2. You’ve studied bundled payment models extensively—how does TEAM differ from previous programs like BPCI or CJR in design and intent?
While TEAM excludes hospitals located in Core-Based Statistical Areas (CBSA) with population centers of less than 10,000 people, it differs from prior bundled payments programs because it includes low volume hospitals if they are located in larger CBSAs and Safety Net Hospitals. Many of these hospitals will have particular challenges to meeting the TEAM requirements.

Prior bundled payments for fusion surgery have all been voluntary, and only included inpatient fusion. TEAM is a mandatory program involving both inpatient and hospital outpatient fusion.

Reconciliation payments for prior bundled payments were specific to hospitals – each hospital’s historical payments were used to define its own unique target price. In TEAM the target price is regionally-based, largely derived from within each of the nine U.S. Census Divisions. Within each fusion episode there is historically a very large variation in the episode costs.

Payment in prior models only impacted their respective service line. In TEAM, the failure to meet the regional price target can result in a significant penalty to a hospital’s Annual Payment Update (applied to hospital services, not just spine fusion services). Furthermore, because it is applied to the APU, any penalty effectively compounds over time.

TEAM also includes requirements intended to facilitate care coordination, such as making a referral for post-acute care to a primary care provider.
3. What early insights are emerging about which hospitals and patients are likely to be included in TEAM, and what might that mean for access or equity in spine care?
Some of the work we will present at the symposium shows that as of August 2025, a total of 716 hospitals were randomly selected to participate in TEAM upon its launch on January 1, 2026, along with an additional 10 voluntary participant hospitals. We linked hospitals to the American Hospital Association Annual Survey to show that TEAM hospitals were significantly larger in terms of bed count, total admissions, Medicare discharges and total expenses, and were more likely to be Level I trauma centers, not-for-profit hospitals, teaching/academic affiliated, and to provide orthopedic services. But we also show that TEAM hospitals tend to have higher 30-day episode costs compared to control hospitals, which means that they face a greater financial reduction goal.
4. From a practical standpoint, how can spine surgeons and hospital administrators begin preparing now to align clinical and financial strategies under TEAM?
Hospitals need to engage in designing efficient clinical pathways aimed at eliminating unnecessary care, ensuring smooth care transitions, reducing and managing complications where they can, and carefully assessing the necessity of higher invasive fusion which generally involve greater risks for complications and have higher costs. Under bundled payments, hospitals may work on pathway redesign (eg, enhances recovery protocols), control risk pre-operatively (eg, control diabetes), vertically integrate with post-acute care providers to manage costs, and reduce cost through implant/device standardization.
5. What do you hope attendees will take away from this session—particularly those who may soon be practicing in hospitals subject to these new mandatory bundles?
The intended and unintended effects of TEAM are still unknown, but the financial pressure it places on participant hospitals is significant. TEAM, like prior bundled payment, fundamentally shift the financial risk of patients onto hospitals. This can provide both financial opportunity and threats. Surgeons in selected hospitals should be engaged in their hospital’s efforts to create efficient clinical pathways. More broadly, as Medicare increasingly advances payment reform and value-based models, it will likely be necessary to collect the quality data that is not normally collected outside of clinical trials or health registries.

Today’s Abstracts and Best Papers Showcase Impactful Spine Research

Saturday’s program begins with some of the most anticipated scientific sessions, including presentations of the 2025 NASS Best Papers. Faculty and researchers will spotlight translational breakthroughs, therapeutic advances, and the evolving science behind spine care.

7:00-8:00 AM MST

Translational Research and Therapeutic Advances in Spine
Moderators: Richard L. Skolasky, ScD; John Hesling, MD; Kenneth R. Blank. PhD, Ms, MHA

8:00-9:15 AM MST

Best Papers
Moderators: Allen Chen, MD, MBA, MPH; Brandon Lawrence, MD; John Shin, MD

1:00-2:30 PM MST

From Intervention to Insight: Surgical and Diagnostic Advances
Moderators: Kenneth Blank, PhD, MS, MHA; Morteza Sadeh, MD, PhD

3:30-5:00 PM MST

Enhancing Surgical Precision Through Imaging, Navigation & Technique
Moderators: Eeric Truumees, MD; David A. Wong, MD, MSc, FRCSC; Brandon Lucke-Wold, MD, PhD, MHS

Each session offers concise, valuable presentations, and faculty discussions connecting the latest discoveries with clinical applications. 

Can’t attend in person? Recordings of these and other Annual Meeting sessions will be available after the meeting through the all-new NASS Anytime. Subscribers can stream on-demand content at their convenience and stay current on the latest research and discussions. Subscribers can stream on-demand content at their convenience and stay current on the latest research and discussions. Subscribe at: nassanytime.spine.org

Large Turnout at NASS Coding Course in Denver Hears Important Updates

With the Medicare Physician Fee Schedule (MPFS) Final Rule recently released on October 31, course faculty discussed new changes that are coming for coding with the telehealth, with the inpatient-only list, with changes to the practice.

“Coding is essential because that's the way you communicate with payers, with other doctors, with other health systems,” said Paul Saiz, MD, NASS Coding Committee Co-Vice Chair. “And unless you know how to speak that language, you're dealing with a disadvantage. So to me, coding should be a basic part of any spine surgeon's curriculum.”

Saiz said he wishes every physician would at least every few years come to a coding course because things frequently change.

“Things right now in 2025 are much different than 2015 and 2005,” he said. “So (it’s important that) not only are your coders knowledgeable, but the physicians are knowledgeable because ultimately the physician knows what he did during surgery. Your coder doesn't. And so, I think it's extremely important for physicians to be involved.”

Lahey said in past years coding course attendees were looking for information on specific codes, but now they are wanting knowledge on the full landscape.

“I think now it's broader because with all the rules and regulations, and with authorizations being pre-authorizations and denials from insurance companies, now we kind of want to know how to code,” Lahey said. “We're still here to learn the ins and outs of that, but how do we get paid? Because things just aren't being paid. Things that you have pre-authorized aren't getting paid, even with the authorization.”

Today’s Abstract Presentations: Fast-Moving Insights Across the Spine Spectrum

Friday’s scientific program features a full slate of abstract sessions highlighting emerging research across every corner of spine care. From AI-driven imaging and socioeconomic analyses to innovative surgical techniques and biologic advances, presenters will deliver findings followed by expert discussion to connect data with real-world practice.

9:30-10:30 AM MST

Patient-Centered Strategies to Optimize Spine Surgery Outcomes
Moderators: DJ Kennedy, MD; John Hesling, MD

Surgical Decision-Making in Complex Spine Pathologies
Moderators: Bilal Butt, MD

1:00-2:30 PM MST

Surgical Techniques, Complications, and Outcomes
Moderators: Karin R. Swartz, MD; Ethan Cottrill, MD, PhD, MS

3:30-5:00 PM MST

Recovery, Risk, and Return-to-Function in Spine Surgery
Moderators: Byron Schneider, MD; Vivek Babaria, DO; Jon Hesling, MD

Biomechanics, Technology, and Translational Tools in Spine
Moderators: John G. Finkenberg, MD; Serena S. Hu, MD; Ethan Cottrill, MD, PhD, MS

Each session offers concise, high-impact research designed to inform clinical decision-making and spark new ideas for your own practice.

Can’t attend in person? Recordings of these and other Annual Meeting sessions will be available after the meeting through the all-new NASS Anytime. Subscribers can stream on-demand content at their convenience and stay current on the latest research and discussions. Subscribe at: nassanytime.spine.org

Friday Symposium Highlight: Advanced Measurement of Spino-Pelvic Parameters in Adult Deformity: How New Analyses are Changing Surgical Decision-Making for Both Spine and Hip Surgeons

Today, we are pleased to present a Q&A from David Wong, MD, MSc, FRCSC, who discusses how the symposium came to be, how new measurement tools are changing treatment plans, the role of AI, and what he hopes attendees will gain from the session.

1. What motivated you to organize a session focused specifically on advanced spino-pelvic measurement, and why is this such a pivotal topic right now?
The impetus for our symposium came from recognizing a (somewhat surprising) personal knowledge gap while sharing a patient consultation with our guest speaker Dr. Doug Dennis, Past President of the American Association of Hip and Knee Surgeons (AAHKS). Our patient’s slowly progressive thoraco-lumbar spine deformity had resulted in a change in orientation of the patient’s pelvis and also therefore, associated total hip arthroplasties leading to episodes of hip subluxation.

Despite being Ian Macnab’s Spine Fellow the year his classic article on Hip-Spine Syndrome was published, I had no knowledge of the way our total joint colleagues had integrated our well-known methods of spino-pelvic measurements of deformity into their system of pelvic and acetabular analysis to develop an advanced program of measures which would predict how spine deformity and changes with surgery can directly influence the risk of hip dislocation and the orientation of the acetabular cup should the patient have a total hip arthroplasty.

In speaking to other spine physicians at various meetings, it became apparent that I was not the only one with this knowledge gap. With our aging population and more frequent spine deformity surgeries as well as total hip replacements, it felt like this would be a pivotal topic to present to the entire NASS membership.
2. How are newer measurement tools and analyses changing the way surgeons plan and execute deformity correction?
Even excluding the advanced measurements outlined in our symposium, more sophisticated spino-pelvic measurements have been developed in recent years and integrated into surgical planning as well as surgical technology such as robots used in the correction of spine deformity. There is no one better to update the audience on the current state of integrating spino-pelvic measures than Dr. Serena Hsu, Past President of the Scoliosis Research Society (SRS).
3. What are some of the most important interdisciplinary insights you expect to emerge from this discussion?
There must be interdisciplinary, shared decision making between the hip surgeon, the spine surgeon and the patient for anyone in the identified “at risk” subgroup of patients with hip-spine syndrome. This subgroup consists of patients with a spine deformity who have had or are contemplating a total hip replacement, and the patient. This would ensure that consideration has been given to the potential negative effects that surgery in one area may have on the other.

Further, for our rehab medicine and physiotherapy colleagues, we hope to raise their awareness of the “at risk” group and associated potential problems so that they have an index of suspicion around issues that arise in the course of treatment of these patients. It will be pointed out that the first inkling of a problem in our index patient occurred during a physiotherapy session. His episode of acute buttock pain was fortunately recognized as a problem of hip subluxation and led to a reinvestigation of both his hip and spine problems and their intertwined effects.
4. Dr. Neel Anand will be covering AI in measurement — how do you see AI and digital navigation shaping the next generation of surgical decision-making?
Dr. Anand is something of a “futurist.” He will discuss his vision for how the advent of AI and other tools can change the way we measure spino-pelvic parameters as well as their accuracy. He also has ideas on how advanced measurements and programs such as AI can translate into more realistic surgical planning in terms of attainable correction as well as the best choice of instrumentation, where to position implants and the appropriate sizes to achieve best fixation and correction, as well as aids such as anatomic templates to improve accuracy of instrumentation accuracy.
5. What practical takeaways do you hope attendees will leave with, especially younger surgeons entering an era of more data-driven surgical planning?
Dr. Chris Johnson, one of our young, up and coming deformity surgeons is going to summarize the following take home messages:
• Be aware of the “at risk” subgroup of patients within the hip-spine syndrome umbrella who have a spine deformity and have or are contemplating a total hip arthroplasty
• Recognize that in these patients, surgery on either the hip or the spine without consideration of the effects on the other area may have negative consequences.
• The fully integrated digital operating room is where many of these advanced measurements will ultimately be brought into play.