In This Issue

SpineLine Podcasts

Commentary

Editor's Message Under the Influence: Recent Articles from the Outside Shaping Spine Care Jason Friedrich, MD
From the Desk of the President NASS 2027–2029: Turning Strategy into Action William Mitchell, MD

Current Concepts

Invited Review Social Determinants of Health and Spine Surgery Outcomes: A Literature Overview Vahe Yacoubian, MD, MPH; Adelin Tulcan; Olumide Danisa, MD
The Spine Journal Literature Review Review of Effects of Romosozumab on Bone Strength Around a Pedicle Screw as Evaluated by Biomechanical Computed Tomography-based Virtual Stress Tests in Postmenopausal Women Adrian T.H. Lui, MBBS; Chad Craig, MD; Sravisht Iyer, MD
NASSJ Literature Review Machine Learning Approach to Risk Stratification for Postoperative Hematoma Following Anterior Cervical Spine Surgery Adam D. Winter, MS; Jonathan N. Grauer, MD

Socioeconomics & Politics

Coding Modifier 22— Is It Worth the Effort? R. Dale Blasier, MD, FRCSC, MBA

Research

Patient Safety 2026 North American Spine Society Patient Safety Position Statement on Education, Training, and Competency for Spine Interventions

Ethics

September/October Ethics Reader Poll

NASS News

SpineLine’s 20 Under 40 Class of 2026 Profiles
NASS Recognition Awards: Honoring Leaders in Spine Care
Leaders Share What Tops Their List for NASS 2026
NASS 2026 Friday Best Papers Q&A
NASS 2026 Presidential Guest Speaker: Jennifer Breheny Wallace
Biologics Meeting
In Memoriam: Michael H. Heggeness, MD, PhD
In Memoriam: Gunnar Andersson, MD, PhD
In Memoriam: Ralph Rashbaum, MD
Behind the Mask: Justin Lantz, DPT, OCS, FAAOMPT

Cover

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SpineLine Podcasts

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Editor in Chief Jason Friedrich, MD

Editorial Board

Roberto Acosta-Gomez, MD Dustin Anderson, MD Akhil Chhatre, MD Chad Craig, MD Olumide A. Danisa, MD Edward Dohring, MD Brody Fitzpatrick, MD Jonathan N. Grauer, MD Manish K. Kasliwal, MD Niranjan U. Kavadi, MBBS Noojan Kazemi, MD Matthew Lindsey, MD Kai-Uwe Lewandrowski, MD Philip Louie, MD Mohammed Macki, MD Vivek Mohan, MD, MS Ripul R. Panchal, DO, FACS Ayesha Quddusi, MD Christopher P. Silveri, MD Miles L. Singer, DO Anuj Singla, MD Junho Song, MD Assem Sultan, MD F. Todd Wetzel, MD

Founding Editor in Chief Stuart M. Weinstein, MD, 2000-2006

Past Editors in Chief Eeric Truumees, MD, 2006-2012 Thomas Mroz, MD, 2012-2013 William J. Sullivan, MD, 2013-2018 Jonathan N. Grauer, MD, 2019-2020 F. Todd Wetzel, MD, 2020-2025

Editorial Staff Kelly Campbell, MS, Director of Publications Jeff Karzen, Assistant Director, Publications Jessica Vander Naald, Graphic Designer

Purpose SpineLineTM, a peer-reviewed publication of the North American Spine Society, is published bimonthly to educate and inform NASS members on medical, ethical and policy matters in the field of spine and health care. SpineLine serves as the primary publication for the NASS membership: (1) to educate and inform NASS’ multidisciplinary members on issues of interest and relevance to spine care and research, and assist them in providing quality, cost-effective patient care; and (2) to communicate and promote the policies, professional activities and products of the association.

Statements or opinions expressed in SpineLine are those of the author(s) and do not necessarily represent positions of the North American Spine Society.

© 2026, North American Spine Society, a not-for-profit corporation. ISSN 1531-4111

Disclosure Policy

In compliance with the NASS uniform disclosure policy (available at https://www.spine.org/Portals/0/Assets/Downloads/WhoWeAre/DisclosurePolicy.pdf), SpineLine authors are asked to disclose all financial arrangements. An indicator code (see key at right) reflecting that disclosure (including the supporting company or institution) will appear at the end of each article. Direct or indirect remuneration: Royalties, Stock ownership, Private Investments, Consulting, Speaking and/or teaching arrangements, Trips/travel

Position held in a company: Board of Directors, Scientific Advisory Board, Other office

Support from sponsors: Endowments, Research support, Grants, Fellowship support

Other: Relationships outside the one-year requirement Levels of support: A: $100 to $1000 B: $1,001 to $10,000 C: $10,001 to $25,000 D: $25,001 to $50,000 E: $50,001 to $100,000 F: $100,001 to $500,000 G: $500,001 to $1M H: $1,000,001 to $2.5M I: Greater than $2.5M

Editorial Offices SpineLineTM is published six times a year by the North American Spine Society, 150 Harvester Dr., Suite 111, Burr Ridge, Illinois 60527

Email: jason.friedrich@cuanschutz.edu

jkarzen@spine.org spineline@spine.org

Telephone: 630-230-3600 Toll-free: 866-960-NASS (6277) NASS Website: www.spine.org

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NASS Board of Directors

William Mitchell, MD President Christopher P. Kauffman, MD First Vice President Alan S. Hilibrand, MD Second Vice President Patrick C. Hsieh, MD, MS, MBA Secretary D.J. Kennedy, MD Treasurer Eric J. Muehlbauer, MJ, CAE Executive Director & CEO Richard L. Skolasky, ScD Administration & Developent Council Director Andrew Schoenfeld, MD Education Council Director Steven W. Hwang, MD Evidence Analysis & Research Council Director Karin R. Swartz, MD Health Policy & Advocacy Council Director Michael G. Fehlings, MD, PhD, FRCSC Strategic Growth Council Director Sandeep Gidvani, MD Appointed Member Byron J. Schneider, MD Appointed Member Roger Härtl, MD At-Large Member Noam Stadlan, MD Committee on Ethics & Professionalism Liaison Michael Y. Wang, MD Industry Relations Liaison