July 2019 Edition. Volume XIX

James W. Simmons, Jr.

James W. Simmons, Jr.


In all professional endeavors there are those who lead the way.  Pioneers create the trails for others to follow. In this regard “Walt” Simons (James Walter Simmons, Jr.) 1934-2016 was the pioneer in starting national spine care meetings in the United States.  Intended initially as a means of educating his hospital nurses and medical staff the Challenge Of The Lumbar Spine became the first medical meeting completely devoted to the subject of spine. The simple act of seeking out those physicians specializing in spine research, teaching and clinical practice began the process by which spine care in general and spine surgery in particular have become leading areas of interest in both Orthopedics and Neurosurgery.

At the same time that Harry Farfan, in Canada, was thinking about the creation of an international lumbar spine organization “Walt” Simmons began, to consider in the United States,  the need for a multidisciplinary approach to the treatment of spinal disorders.  “Reflecting back to the earlier years….He noted that hardly anyone wanted to be involved with the treatment of spinal problems (low back pain), partly because of the lack of knowledge, not to mention the lack of training and experience within our educational institutions. Some surgical procedures had been developed for pathologies which were obvious the limited studies; i.e. plain x-rays and myelography. Unfortunately, if the pathology could not be seen on these limited studies, the pain problems were considered to be supratentorial in nature, and the patient accused of malingering or, at best, symptom magnification.”

In what was a unique attitude for its time Walt Simmons was willing to see patients who didn’t have a proven disc herniation, vertebral fracture, tumor or infectious process.  His fortuitous association with neurologist William Advent in San Antonio, Texas gave him the incentive to look further in patients with incapacitating pain associated with radiculopathic abnormalities on their examination.  Other understanding members of his team included physical therapist Diane Rath and industrial nurse Joyce Demski.  With this core team in place the group began to hold local teaching sessions in the early 1970s.

From this beginning Walt Simmons felt that others needed to recognize that a more concentrated interdisciplinary educational effort was needed to address the diagnosis and treatment of low back disorders because they represented a extremely complex challenge in regard to health care. “We initially had the support  of the Orthopedic Department at the University of Texas Health Science Center in San Antonio; however, because it was multi-disciplinary and not directed by orthopedists for orthopedists their support was withdrawn.  We had committed to the nurses and others to put on this program, so we got a line of credit for $25,000 from one of our more friendly bankers and pressed on.  Thus, “The Challenge of The Lumbar Spine 78″ began to take form.”

The “Challenge” was unique from the beginning in that it departed from the characteristic turf provincialism characteristic of medical groups and invited orthopedists, neurosurgeons, family practitioners, nurses, physical therapists, occupational therapists, lawyers, insurance adjusters and other interested parties from the
beginning.  In 1982 chiropractors were added to those professionals being officially invited.

Listed below are the Challenge programs, locations, and course chairmen who contributed to this important first effort.  Clearly the “Challenge” set the tone for what followed in the United States regarding low back care.  Although the programs were held only in the United States the faculty was universal and the approach continued to reflect that of a team working together for the patient’s benefit. Walt Simmons attracted other colleagues to be chairmen of “Challenge” programs which continued “as long as the demand was there.”  By 1989  the spine “ball” was rolling and the baton had been passed to other spine organizations.

The conservatism of health care has been it’s boon as well as its bane. Walt Simmons’ efforts to bring together different disciplines for the benefit of the patient with low back problems was unique and the timing was important.  Being a pioneer is never easy but it’s a heck of a great deal easier for a physician to “buck the system” than it was for someone like Sister Elizabeth Kenny. The Burton Report® is pleased to acknowledge the role of “Challenge of the Lumbar Spine” in its important educational task from 1978 to 1989.

Challenge of the Lumbar Spine Programs

Year Location Chairman
1978 San Antonio James W. Simmons
1980 San Antonio James W. Simmons
1981 Dallas David Selby
1982 San Francisco` Arthur H. White
1983 San Antonio James W. Simmons
1984 New Orleans Anthony Dwyer
1985 Minneapolis Charles V. Burton
1986 San Francisco Arthur W. White
1987 New York Casey K. Lee
1988 San Antonio James W. Simmons
1989 San Francisco Arthur W. White


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