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 Watters III, Chung Chek Wong, Jessica J. Wong, Hainan Yu, Selcen Yüksel

October 2018, Volume 27, Issue 6, pp 776 - 785 Original Article Read Full Article 10.1007/s00586-018-5722-x

First Online: 27 August 2018


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.


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.


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.


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.[Figure not available: see fulltext.]

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