Sami I. AlEissa, Koji Tamai, Faisal Konbaz, Ahmed Alturkistany, Thomas R. Blattert, Harvinder S. Chhabra, Giuseppe Costanzo, Edward J. Dohring, Frank Kandziora, Ralph Kothe, Bernardo Misaggi, Eric J. Muehlbauer, Paulo Pereira, Shanmuganathan Rajasekaran, William J. Sullivan, Eeric Truumees, Yahya Alqahtani, Hana I. Alsobayel, Joerg Franke, Marco G. A. Teli, Jeffrey C. Wang, Hazzaa M. Al-Hazzaa, Majed Nasser Alosaimi, Sigurd Berven, Marco Brayda-Bruno, Andrew M. Briggs, Jamiu O. Busari, Antonello-Valerio Caserta, Pierre Côté, Marco Crostelli, Michael G. Fehlings, Robert Gunzburg, Sami Haddadin, Joseph Ihm, Alan S. Hilibrand, Andrea Luca, Mazza Osvaldo, Tim Pigott, Dominique A. Rothenfluh, Carlo Ruosi, Louis-Rachid Salmi, Ajoy P. Shetty, Kern Singh, Alexander R. Vaccaro, David A. Wong, Mehmet Zileli, Margareta Nordin

August 2021, Volume 30, Issue 8, pp 2091 - 2101 Review Article Read Full Article 10.1007/s00586-021-06890-5

First Online: 09 June 2021

SPINE20 A global advocacy group promoting evidence-based spine care of value


The Global Burden of Diseases (GBD) Studies have estimated that low back pain is one of the costliest ailments worldwide. Subsequent to GBD publications, leadership of the four largest global spine societies agreed to form SPINE20. This article introduces the concept of SPINE20, the recommendations, and the future of this global advocacy group linked to G20 annual summits.


The founders of SPINE20 advocacy group coordinated with G20 Saudi Arabia to conduct the SPINE20 summit in 2020. The summit was intended to promote evidence-based recommendations to use the most reliable information from high-level research. Eight areas of importance to mitigate spine disorders were identified through a voting process of the participating societies. Twelve recommendations were discussed and vetted.


The areas of immediate concern were “Aging spine,” “Future of spine care,” “Spinal cord injuries,” “Children and adolescent spine,” “Spine-related disability,” “Spine Educational Standards,” “Patient safety,” and “Burden on economy.” Twelve recommendations were created and endorsed by 31/33 spine societies and 2 journals globally during a vetted process through the website and during the virtual inaugural meeting November 10–11, 2020 held from the G20 platform.


This is the first time that international spine societies have joined to support actions to mitigate the burden of spine disorders across the globe. SPINE20 seeks to change awareness and treatment of spine pain by supporting local projects that implement value-based practices with healthcare policies that are culturally sensitive based on scientific evidence.

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