NASS Insider

May 06, 2022

NASS Positions on Specialty Scope of Practice and on Arthrodesis of the Spine

The North American Spine Society is a global multidisciplinary professional society dedicated to improving patient safety and the quality of patient spinal care in the treatment of spinal disorders.

On October 14th 2021, a multi-society scope of practice position statement was distributed regarding Arthrodesis of the Spine by the Non-Spine Surgeon.

NASS was not invited to contribute to nor approached to sign on to this position statement, but after it was issued several NASS members requested our thoughts on the issue. A NASS multi-specialty task force deliberated our position on subspecialty scope of practice, and the NASS Board reviewed the multi-society statement. With regard to arthrodesis of the spine by a non-spine surgeon, NASS is in general agreement with the position statement issued by the multi-society group. The following represent NASS’ positions on Specialty Scope of Practice and on Arthrodesis of the Spine.

NASS Statement on Specialty Scope of Practice:
NASS is a global multidisciplinary organization dedicated to improving the care of patients with spinal disorders. Our membership includes both surgical and non-surgical specialists. NASS does not certify or credential specific training paths, and specifically works to encourage dialogue, education, and cooperation across disciplines. NASS’s position on scope of practice issues is consistent with its mission to promote high quality, evidence-based spine care. NASS believes that patient safety and quality of care should be of the highest priority in the credentialing process of any physician who performs spinal procedures or surgeries. Physicians performing spinal procedures should be appropriately experienced and trained to provide and manage these procedures, and at a minimum should have completed a formal residency and/or fellowship program during which they learn the science and clinical skills fundamental to the performance of these procedures. They should also be licensed to perform these procedures.

NASS Position Statement on Arthrodesis of the Spine:
Optimal patient care and patient safety are best served when surgical diseases affecting the spine are managed by neurosurgeons and orthopaedic spinal surgeons trained in the full spectrum of spinal anatomy and biomechanics, including instrumentation and fusion techniques. A unique range and depth of surgical skills are acquired throughout the neurosurgeon’s and orthopaedic surgeon’s career, including residency, fellowship, and post-training continuing education and practice. Patient safety advocates that only qualified surgeons administer procedures that affect the structure and biomechanics of patients with spine problems. Arthrodesis or any other intervention that alters the biomechanics of the spine should not be performed by practitioners trained in fields other than neurosurgery and orthopaedic spinal surgery.

Edward J Dohring, MD
President, North American Spine Society