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European Spine Journal

, Volume 27, Supplement 6, pp 776–785 | Cite as

The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability in low- and middle-income communities

  • Scott Haldeman
  • Margareta Nordin
  • Roger Chou
  • Pierre Côté
  • Eric L. Hurwitz
  • Claire D. Johnson
  • Kristi Randhawa
  • Bart N. Green
  • Deborah Kopansky-Giles
  • Emre Acaroğlu
  • Arthur Ameis
  • Christine Cedraschi
  • Ellen Aartun
  • Afua Adjei-Kwayisi
  • Selim Ayhan
  • Amer Aziz
  • Teresa Bas
  • Fiona Blyth
  • David Borenstein
  • O’Dane Brady
  • Peter Brooks
  • Connie Camilleri
  • Juan M. Castellote
  • Michael B. Clay
  • Fereydoun Davatchi
  • Jean Dudler
  • Robert Dunn
  • Stefan Eberspaecher
  • Juan Emmerich
  • Jean Pierre Farcy
  • Norman Fisher-Jeffes
  • Christine Goertz
  • Michael Grevitt
  • Erin A. Griffith
  • Najia Hajjaj-Hassouni
  • Jan Hartvigsen
  • Maria Hondras
  • Edward J. Kane
  • Julie Laplante
  • Nadège Lemeunier
  • John Mayer
  • Silvano Mior
  • Tiro Mmopelwa
  • Michael Modic
  • Jean Moss
  • Rajani Mullerpatan
  • Elijah Muteti
  • Lillian Mwaniki
  • Madeleine Ngandeu-Singwe
  • Geoff Outerbridge
  • Shanmuganathan Rajasekaran
  • Heather Shearer
  • Matthew Smuck
  • Erkin Sönmez
  • Patricia Tavares
  • Anne Taylor-Vaisey
  • Carlos Torres
  • Paola Torres
  • Alexander van der Horst
  • Leslie Verville
  • Emiliano Vialle
  • Gomatam Vijay Kumar
  • Adriaan Vlok
  • William WattersIII
  • Chung Chek Wong
  • Jessica J. Wong
  • Hainan Yu
  • Selcen Yüksel
Original Article

Abstract

Purpose

Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources.

Methods

Leading spine clinicians and scientists around the world were invited to participate. The interprofessional, international team consisted of 68 members from 24 countries, representing most disciplines that study or care for patients with spinal symptoms, including family physicians, spine surgeons, rheumatologists, chiropractors, physical therapists, epidemiologists, research methodologists, and other stakeholders.

Results

Literature reviews on the burden of spinal disorders and six categories of evidence-based interventions for spinal disorders (assessment, public health, psychosocial, noninvasive, invasive, and the management of osteoporosis) were completed. In addition, participants developed a stratification system for surgical intervention, a classification system for spinal disorders, an evidence-based care pathway, and lists of resources and recommendations to implement the GSCI model of care.

Conclusion

The GSCI proposes an evidence-based model that is consistent with recent calls for action to reduce the global burden of spinal disorders. The model requires testing to determine feasibility. If it proves to be implementable, this model holds great promise to reduce the tremendous global burden of spinal disorders.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Global burden of disease Spinal diseases Quality of health care Neck pain Back pain 

Notes

Funding

The Global Spine Care Initiative and this study were funded by grants from the Skoll Foundation and NCMIC Foundation. World Spine Care provided financial management for this project. The funders had no role in study design, analysis, or preparation of this paper.

Compliance with ethical standards

Conflict of interest

SH declares funding to UOIT from Skoll Foundation, NCMIC Foundation through World Spine Care. Clinical Policy Advisory Board and stockholder, Palladian Health. Advisory Board, SpineHealth.com. Book Royalties, McGraw Hill. Travel expense reimbursement—CMCC Board. MN declares funding from Skoll Foundation and NCMIC Foundation through World Spine Care; Co-Chair, World Spine Care Research Committee. Palladian Health, Clinical Policy Advisory Board member. Book Royalties Wolters Kluwer and Springer. Honoraria for speaking at research method courses. RC declares funding from AHRQ to conduct systematic reviews on treatments for low back pain within last 2 years and honoraria for speaking at numerous meetings of professional societies and nonprofit groups on topics related to low back pain (no industry sponsored talks). PC is funded by a Canada Research Chair in Disability Prevention and Rehabilitation at the University of Ontario Institute of Technology and declares funding to UOIT from Skoll Foundation, NCMIC Foundation through World Spine Care. Canadian Institutes of Health Research Canada. Research Chair Ontario Ministry of Finance. Financial Services Commission of Ontario. Ontario Trillium Foundation, ELIB Mitac. Fond de Recherche and Sante du Quebec. EH declares he is a consultant for: RAND Corporation; EBSCO Information Services; Southern California University of Health Sciences; Western University of Health Sciences Data and Safety Monitoring Committee, chair, Palmer Center for Chiropractic Research, research committee co-chair, World Spine Care. CDJ is president of Brighthall Inc; she is an NCMIC Board of Director; however, neither she nor NCMIC board makes funding decisions for the NCMIC Foundation; the views in this article are those of the authors and not those of Stanford University, Stanford Health Care, or Qualcomm. KR declares funding to UOIT from Skoll Foundation, NCMIC Foundation through World Spine Care. BNG receives speaker fees and travel reimbursement from NCMIC Speakers’ Bureau; he is secretary of Brighthall Inc; the views in this article are those of the authors and not those of Stanford University, Stanford Health Care, or Qualcomm. DKG declares travel expenses: CMCC to present at the WSC Spine Conference in Botswana. EAc declares grants: Depuy Synthes Spine, Medtronic; Speaker’s bureau: AOSpine, Zimmer Biomet. AA declares no COI. EA declares funding to UOIT from Skoll Foundation, NCMIC Foundation through World Spine Care. TB declares European Spine Journal provided a grant to investigate scoliosis. OB declares he is a consultant for: Pacira Pharmaceuticals, Inc., Palladian Health; travel expenses: World Spine Care; and stipend: World Spine Care. PB declares contribution to salary for Global Musculoskeletal Alliance (G-MUSC), the Bone and Joint Decade work. JMC declares funding from Spanish Government Grant ESPY 112/18. SE is an employee of the Botswana Ministry of Health and Wellness. CG declares travel expenses: Palmer College to GSCI meetings; is consultant: American Chiropractic Association, Spine IQ, Healthwise, Quality Insights of Pennsylvania, RAND Co., Prezacor, Inc. (Stock Options); PCORI (board member); and grants from Collaborative Care for Veterans with Spine pain and Mental Health Issues. NIH/Kiernan Chiropractic Care in Rehabilitation at Crotched Mountain: Crotched Mountain Private Sector Integrated Chiropractic Study N/A. NCMIC Foundation Chiropractic services, Assessment of Chiropractic Treatment for Low Back Pain; RAND Subcontract, Department of Defense Prime Award #W81XWH-11-2-017 Sub #9920110071. JH declares his research group has extensive funding from Danish public funding agencies, the European Union, and Danish charities. MH declares travel support from World Spine Care. JM declares general research resources from USF Research Center and research grants from funding agencies: FEMA, US Department of Homeland Security (EMW-2013-FP-00723); Palladian Health Advisory board: Clinical Policy and Advisory Board; Intellectual property rights: inventor of Web-based system to deliver exercise (Employer—USF: copyright holder). TM declares fellowship grant-Medtronics. JM is a WSC Board Member. EM declares AO Spine Africa Faculty courses—honorarium. GO declares he is a consultant and receives travel support as clinic director, World Spine Care. HR declares funding to UOIT from Skoll Foundation, NCMIC Foundation through World Spine Care. MS declares he is a scientific advisor, NuSpine; consultant, and State Farm. ES declares funding from Başkent University Research Fund. ATV declares funding to UOIT from Skoll Foundation, NCMIC Foundation through World Spine Care. LV declares funding to UOIT from Skoll Foundation and NCMIC Foundation through World Spine Care. WW declares Palladian Health Clinical Policy Advisory Board member. JJW declares funding to UOIT from Skoll Foundation, NCMIC Foundation through World Spine Care. HY declares funding to UOIT from Skoll Foundation, NCMIC Foundation through World Spine Care. Remaining authors declare that they have no conflict of interest.

Supplementary material

586_2018_5722_MOESM1_ESM.pptx (176 kb)
Supplementary material 1 (PPTX 175 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Epidemiology, School of Public HealthUniversity of California Los AngelesLos AngelesUSA
  2. 2.Department of NeurologyUniversity of California, IrvineIrvineUSA
  3. 3.World Spine CareSanta AnaUSA
  4. 4.Departments of Orthopedic Surgery and Environmental MedicineNew York UniversityNew YorkUSA
  5. 5.World Spine Care EuropeHolmfirthUK
  6. 6.Department of Medical Informatics and Clinical EpidemiologyOregon Health and Science UniversityPortlandUSA
  7. 7.Department of MedicineOregon Health and Science UniversityPortlandUSA
  8. 8.Faculty of Health SciencesUniversity of Ontario Institute of TechnologyOshawaCanada
  9. 9.UOIT-CMCC Centre for Disability Prevention and RehabilitationTorontoCanada
  10. 10.Office of Public Health StudiesUniversity of Hawai‘iMānoa, HonoluluUSA
  11. 11.National University of Health SciencesLombardUSA
  12. 12.Qualcomm Health CenterStanford Health CareSan DiegoUSA
  13. 13.Department of ResearchCanadian Memorial Chiropractic CollegeTorontoCanada
  14. 14.Department of Family and Community MedicineUniversity of TorontoTorontoCanada
  15. 15.ARTES Spine CenterAnkaraTurkey
  16. 16.Certification Program in Insurance Medicine and MedicoLegal Expertise, Faculty of MedicineUniversity of MontrealTorontoCanada
  17. 17.Division of General Medical Rehabilitation, Multidisciplinary Pain CentreGeneva University HospitalsGenevaSwitzerland
  18. 18.Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain CentreGeneva University HospitalsGenevaSwitzerland
  19. 19.Ridge Regional HospitalGhana World Spine CareAccraGhana
  20. 20.ARTES Spine CenterAcibadem UniversityAnkaraTurkey
  21. 21.Orthopaedics and Spine DepartmentGhurki Trust Teaching Hospital Lahore PakistanLahorePakistan
  22. 22.Department of Surgery, Hospital Universitario and Politecnico La FeValencia UniversityValenciaSpain
  23. 23.Concord Clinical SchoolUniversity of SydneyConcordAustralia
  24. 24.Arthritis and Rheumatism AssociatesThe George Washington University Medical CenterPotomacUSA
  25. 25.World Spine CareTampaUSA
  26. 26.Centre for Health Policy, School of Population and Global HealthUniversity of MelbourneToorak, MelbourneAustralia
  27. 27.St Michael’s HospitalNorth YorkCanada
  28. 28.National School of Occupational MedicineCarlos III Institute of HealthMadridSpain
  29. 29.Physical Medicine and Rehabilitation DepartmentUniversity ComplutenseMadridSpain
  30. 30.Rehabilitation Care Line, Physical Medicine and RehabilitationCincinnati Veterans Affairs Medical CenterCincinnatiUSA
  31. 31.Rheumatology Research CenterTehran University of Medical SciencesTehranIran
  32. 32.Department of RheumatologyHFR Fribourg - Hospital CantonalFribourgSwitzerland
  33. 33.Department of Orthopaedic SurgeryUniversity of Cape TownCape TownSouth Africa
  34. 34.Groote Schuur HospitalCape TownSouth Africa
  35. 35.Department of OrthopedicsPrincess Marina HospitalGaboroneBotswana
  36. 36.University of La PlataLa PlataArgentina
  37. 37.Department of Orthopedic Surgery (retired)New York UniversityPiermontUSA
  38. 38.Panorama Medi ClinicCape TownSouth Africa
  39. 39.Palmer College of ChiropracticDavenportUSA
  40. 40.The Spine Institute for QualityDavenportUSA
  41. 41.Nottingham University HospitalsEdwalton, NottinghamUK
  42. 42.Emergency MedicineCarlsbadUSA
  43. 43.Mohammed VI University of Health Sciences (UM6SS)CasablancaMorocco
  44. 44.Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
  45. 45.Nordic Institute of Chiropractic and Clinical BiomechanicsOdenseDenmark
  46. 46.Department of AnesthesiologyUniversity of Kansas Medical CenterKansas CityUSA
  47. 47.College of Rehabilitative Sciences, Doctor of Physical Therapy ProgramUniversity of St. Augustine for Health SciencesSan MarcosUSA
  48. 48.School of Sociological and Anthropological StudiesUniversity of OttawaOttawaCanada
  49. 49.Institut Franco-Européen de ChiropraxieToulouseFrance
  50. 50.U.S. Spine and Sport FoundationSan DiegoUSA
  51. 51.Canadian Memorial Chiropractic CollegeTorontoCanada
  52. 52.ARTES Ankara Spine CentreLife Gaborone HospitalGaboroneBotswana
  53. 53.Cleveland ClinicLerner College of MedicineClevelandUSA
  54. 54.Canadian Memorial Chiropractic College, President EmeritaTorontoCanada
  55. 55.MGM School of PhysiotherapyMahatma Gandhi Mission Institute of Health SciencesNavi MumbaiIndia
  56. 56.Moi University/Moi Teaching and Referral HospitalEldoretKenya
  57. 57.Law Society of KenyaNairobiKenya
  58. 58.Faculty of Medicine and Biomedical SciencesThe University of Yaoundé IYaoundeCameroon
  59. 59.World Spine Care and Canadian Memorial Chiropractic CollegeChelseaCanada
  60. 60.Department of Orthopaedics and Spine SurgeryGanga HospitalCoimbatoreIndia
  61. 61.Department of Orthopaedic SurgeryStanford UniversityRedwood CityUSA
  62. 62.Department of Neurological SurgeryBaşkent University School of MedicineAnkaraTurkey
  63. 63.Department of Medical Imaging, The Ottawa HospitalUniversity of OttawaOttawaCanada
  64. 64.Exercise Science Laboratory, School of Kinesiology, Faculty of MedicineUniversidad Finis TerraeSantiagoChile
  65. 65.Department of SurgeryUniversity of NamibiaWindhoekNamibia
  66. 66.Central HospitalWindhoekNamibia
  67. 67.Catholic University of ParanaCuritibaBrazil
  68. 68.AMRI Hospitals, Salt LakeKolkataIndia
  69. 69.Division of NeurosurgeryUniversity of StellenboschBellvilleSouth Africa
  70. 70.Department of Orthopedic, Weill Cornell Medical School and Institute of Academic MedicineHouston Methodist HospitalHoustonUSA
  71. 71.Department of Orthopedic SurgeryUniversity of Texas Medical BranchGalvestonUSA
  72. 72.Sarawak General HospitalKuchingMalaysia
  73. 73.Department of BiostatisticsAnkara Yildirim Beyazit University Medical SchoolAnkaraTurkey

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