Christopher M. Bono, M.D., has worn many hats in his time with the North American Spine Society (NASS), but one of the ones he is most proud of is his time serving as president of the prestigious society.
Bono will be awarded the Past President’s Award at the upcoming NASS conference in September to recognize his continuing contributions to the Society and its mission after serving as president during the 2015-2016 term.
To be considered for the award, a candidate must have served at least two years prior.
Since the inception of his membership to NASS in 2003, Bono has served on many different committees and since 2018 has served as the editor-of-chief of The Spine Journal.
He is also the executive vice chair of the department of orthopaedic surgery and program director of the Harvard Combined Orthopaedic Residency Program at Massachusetts General Hospital in Boston. In addition, he serves as a professor of orthopaedic surgery at Harvard Medical School.
Leading NASS
Bono talked to Orthopedics This Week about his experience leading the Society and his passion for spine excellence.
“I have lots of memorable moments from my presidency,” he said. “The society was still recovering from the Infuse debacle at the time and we had to make a lot of tough decisions and heal ties with companies. Bringing them back to our meeting was a very symbolic moment for them,” he explained.
Bono is referring to a controversy that was sparked after a June 2011 The Spine Journal Infuse article alleged that some researchers were biased because of payments from the maker of Infuse, Medtronics.
It called into question the close ties between some surgeons and medical device companies. This led to strained relationships between NASS and companies like Medtronic as well as other societies. It also affected NASS’s own membership ranks.
Since then, the Society has worked hard to repair those relationships while maintaining the ethical integrity of the Society.
Bonos is also proud of his work related to reimbursement procedures.
“We also got the Coverage Committee off the ground. I realized people were very interested in what NASS had to say about the coverage of procedures. It is very satisfying to see the committee has a life of its own now,” he added.
Bono shared that it was always a dream of his to serve as president of NASS.
“I thought it was such an amazing thing. I saw past leaders who were a who’s who of spine and never thought I could be that person. After the luster fell off and I saw all the tough decisions that needed to be made, I realized I had something to contribute.”
He explained, “It was an education for me on leadership. How to get people with direct opposing views to come to an agreement.”
Power of Scholarship
Bono’s perspective on spine surgery research has also been shaped by his time as editor-in-chief of the journal.
On what people might not realize about what goes into publishing a journal like this, he said, “probably the sheer volume of what you have to do and having to constantly make uncomfortable decisions about other people’s work.”
About 70% of articles are rejected, he said.
“I feel bad saying no. They put a lot of time and effort into their research. It was tough in the beginning, however I had to look into the future at what would this study contribute to the field. It doesn’t mean the study is not worth publishing. It is just not right for the journal at that time. It is a privilege to publish in The Spine Journal.”
The future of spine surgery, he said, should focus more on being better at patient selection to improve outcomes and less on technical aspects.
“Quite frankly, it is just not as important. I am not enthralled with robotics.”
Bono believes that matching the right patients with the right surgery is the key to improving outcomes and effectively relieving symptoms. There is so much data, especially on risk factors, that are underutilized in developing patient-specific risk and outcome profiles.
Improving Outcomes
Bono’s passion for spine surgery excellence comes through in everything he does, but he admitted that when he was just starting his medical training, he never thought he would become a spine surgeon.
He thought he might become a total joint surgeon or do general orthopedics.
“I viewed myself as a technician. I was good with my hands and enjoyed pulling things apart and putting them back together,” he explained.
‘What pushed me into spine was I wanted to do diagnostics as well. I was using my brain the most in clinic trying to decipher the cause of symptoms. The answer isn’t always easy to find. It makes me happy to be able to find an easy solution. And the patients are grateful and happy.”
Bono started his medical training in New York at SUNY Downstate College of Medicine and then did his orthopedic residency at UMDNJ New Jersey Medical School.
He moved to San Diego, California, for his spine fellowship at the University of California San Diego Medical Center where he worked under Drs. Chris Kauffman and Steve Garfin. Garfin is also a past NASS president.
At Massachusetts General Hospital in Boston, Bono treats adult patients with cervical stenosis, herniated disc, lumbar stenosis, myelopathy, radiculopathy, spondylolisthesis, and spondylosis.
His previous publications have included studies on lumbar fusion trends for degenerative disorders, and patient outcomes after lumbar discectomy, in particular the relationships between disc size and early postoperative outcomes.
Currently his research in the Orthopaedic Augmentation, Surgical Innovation, and Interactive Systems Lab or OASIIS at Massachusetts General Hospital, focuses on using interactive medical and virtual reality to assess patient outcomes.
Bono said they are starting with the shoulder because it’s less complex than the spine.
The North American Spine Society is a medical society for health care professionals who specialize in spine care. The mission of the society, which was founded in 1985, is to promote evidence-based and ethical spine care.
The 2024 NASS 39th Annual Meeting will take place September 25 through September 28 in Chicago at McCormick Place, West Building.
