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European Spine Journal
Published in: European Spine Journal 6/2018

01-09-2018 | Original Article

The Global Spine Care Initiative: public health and prevention interventions for common spine disorders in low- and middle-income communities

Authors: Bart N. Green, Claire D. Johnson, Scott Haldeman, Edward J. Kane, Michael B. Clay, Erin A. Griffith, Juan M. Castellote, Matthew Smuck, Shanmuganathan Rajasekaran, Eric L. Hurwitz, Margareta Nordin, Kristi Randhawa, Hainan Yu

Published in: European Spine Journal | Special Issue 6/2018

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Abstract

Purpose

The purpose of this study was to develop recommendations for prevention interventions for spinal disorders that could be delivered globally, but especially in underserved areas and in low- and middle-income countries.

Methods

We extracted risk factors, associations, and comorbidities of common spinal disorders (e.g., back and neck pain, spinal trauma, infection, developmental disorders) from a scoping review of meta-analyses and systematic reviews of clinical trials, cohort studies, case control studies, and cross-sectional studies. Categories were informed by the Global Spine Care Initiative (GSCI) classification system using the biopsychosocial model. Risk factors were clustered and mapped visually. Potential prevention interventions for individuals and communities were identified.

Results

Forty-one risk factors, 51 associations, and 39 comorbidities were extracted; some were associated with more than one disorder. Interventions were at primary, secondary, tertiary, and quaternary prevention levels. Public health-related actions included screening for osteopenia, avoiding exposure to certain substances associated with spinal disorders, insuring adequate dietary intake for vitamins and minerals, smoking cessation, weight management, injury prevention, adequate physical activity, and avoiding harmful clinical practices (e.g., over-medicalization).

Conclusion

Prevention principles and health promotion strategies were identified that were incorporated in the GSCI care pathway. Interventions should encourage healthy behaviors of individuals and promote public health interventions that are most likely to optimize physical and psychosocial health targeting the unique characteristics of each community. Prevention interventions that are implemented in medically underserved areas should be based upon best evidence, resource availability, and selected through group decision-making processes by individuals and the community.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.
Appendix
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Metadata
Title
The Global Spine Care Initiative: public health and prevention interventions for common spine disorders in low- and middle-income communities
Authors
Bart N. Green
Claire D. Johnson
Scott Haldeman
Edward J. Kane
Michael B. Clay
Erin A. Griffith
Juan M. Castellote
Matthew Smuck
Shanmuganathan Rajasekaran
Eric L. Hurwitz
Margareta Nordin
Kristi Randhawa
Hainan Yu
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 6/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-018-5635-8

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