I’m honored and excited to write to you as the 7th Editor in Chief (EIC) of SpineLine in its 26th year of publication. Gratitude compels me to publicly thank Bill Sullivan and Todd Wetzel as two of many fantastic mentors. Bill encouraged me to get involved with NASS a long time ago and has opened many doors for me along the way. I lucked out with the opportunity to work closely with Todd Wetzel at SpineLine over the last several years.

As EIC, I hope to carry forward Todd's editorial style that blends thoughtfulness, humility, humor, and candor. Working for SpineLine is fun because of the people involved and the community feeling it provides. I’m grateful to be here working with NASS where I’m usually in a room of people smarter than me.

I’ve always appreciated NASS for its multidisciplinary foundation and SpineLine for its concise and clinically practical content, as well as its ability to message timely information to a diverse group of spine specialists. I’m devoted to maintaining a publication that is high-yield, clinically practical, thought-provoking, informative, and easy to access. I think SpineLine has an ever-greater role for messaging and informing in the era of AI and information overload.

In preparing this first column, I wanted to slow down, look back, and appreciate past articles that stood out as both influential and representative of SpineLine’s mission.  After re-reading some past articles, I chose this one to highlight SpineLine’s value: “Failed Back Surgery Syndrome is the Problem—Persistent Spinal Pain Syndrome is the Solution” authored by Brian Simpson, MD, and colleagues and published in the July/August 2022 issue.1

Reading this article and listening to the associated podcast gives me hope and optimism for future collaborative work. Dr. Simpson informs us that work on this subject began back in 2017 when a small, international group of spine surgeons decided change was needed. A panel of 25 multidisciplinary experts (including our own Todd Wetzel) were then convened to articulate the problems with Failed Back Surgery Syndrome (FBSS) and systematically work through best alternatives.2 This panel explained why language and word choices impact the health of our patients and our specialty, and how poor labeling can impede research and appropriate treatment. What may have started as an exercise in semantics evolved into to a multidisciplinary discussion about why spine reoperation rates are higher than other nonmalignant conditions, why pain of spinal origin is so common and so disabling, and how the terms “failed” or “chronic” can be misleading and impeding. Ultimately, their conclusions were refreshingly simple and practical, and their recommendations were actionable.

They concluded that as the only vertebrate species to fully adopt an upright posture, humans are still in an interim stage of evolution with respect to constructing a spine that can handle the unique forces of upright posture over decades.3,4 In other words, Dr. Simpson explains “human beings are intrinsically vulnerable” to pain of spinal origin. That became their foundation to build on.

This group of thought leaders did what AI still struggles to do: question medical dogma, create a novel framework that incorporates art, science, expert experience, and humans’ emotion-driven expectations. They took pride in understanding even subtle nuance in terminology. Their solution was PSPS to replace FBSS, and differentiate PSPS from the label “chronic pain after spinal surgery” and other chronic pain conditions.5,6,7 They added subtypes for patients who have had optimal non-surgical care (PSPS Type I) and who have had spine surgery (PSPS Type II). Their framework captured the complexity and layers of spinal pain.

I encourage you to look at each of their publications, including the original article on the topic published in Pain Medicine2 in 2021 (along with some of the 65+ subsequent papers citing that original article), their SpineLine summary, and Dr. Simpson’s associated NASS podcast interview.1

Hopefully, we will see this work integrated into the ICD-11 in the coming years and more collaborative articles focused on the terms we use to label the conditions we diagnose and treat. For instance, some of the same PSPS authors recently published an implementation recommendation for PSPS and a framework better labelling diagnostic certainty.8 I’d love to see future work further tackle the overly broad term “chronic” and better define acute on chronic, relapsing-remitting, episodic, recurrent, waxing-waning, intermittent, etc., for the various enduring spinal conditions we treat.

Important presentations, articles, and research can be lost in the massive inflow of new information. I’m committed to ensuring that SpineLine continues to offer a platform to bring good work back into our collective consciousness and hopefully help influence positive change.

On that note, this issue of SpineLine highlights some of the great work discussed at the recent NASS 2025 Annual Meeting in Denver, in addition to presenting the usual high-yield content, news, and coding updates. I think this issue will give you a sense of the tremendous quality of NASS meeting symposia, while also demonstrating the diversity of topics and issues that affect spine specialists daily. In the President’s column, new NASS President William Mitchell boldly forecasts changes coming to spine surgery in 2026, simultaneously exciting and scary. Please enjoy this power-packed, post-Annual Meeting issue. I hope it helps keep the momentum going from an excellent Annual Meeting.