The Global Spine Care Initiative: care pathway for people with spine-related concerns

Haldeman S 1 , Johnson CD 2 , Chou R 3 , Nordin M 4 , Côté P 5 , Hurwitz EL 6 Show all authors , Green BN 7 , Cedraschi C 8 , Acaroğlu E 9 , Kopansky-Giles D 10 , Ameis A 11 , Adjei-Kwayisi A 12 , Ayhan S 13 , Blyth F 14 , Borenstein D 15 , Brady O 16 , Brooks P 17 , Camilleri C 18 , Castellote JM 19 , Clay MB 20 , Davatchi F 21 , Dunn R 22 , Goertz C 23 , Griffith EA 24 , Hondras M 25 , Kane EJ 26 , Lemeunier N 27 , Mayer J 28 , Mmopelwa T 29 , Modic M 30 , Moss J 31 , Mullerpatan R 32 , Muteti E 33 , Mwaniki L 34 , Ngandeu-Singwe M 35 , Outerbridge G 36 , Randhawa K 5 , Shearer H 37 , Sönmez E 38 , Torres C 39 , Torres P 40 , Verville L 5 , Vlok A 41 , Watters W 42 , Wong CC 43 , Yu H 5

Affiliations 

  • 1 Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
  • 2 National University of Health Sciences, Lombard, IL, USA. globalspinecareinitiative@gmail.com
  • 3 Department of Medical Informatics and Clinical Epidemiology and Department of Medicine, Oregon Health & Science University, Portland, OR, USA
  • 4 Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
  • 5 Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
  • 6 Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
  • 7 National University of Health Sciences, Lombard, IL, USA
  • 8 Division of General Medical Rehabilitation and Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
  • 9 ARTES Spine Center, Ankara, Turkey
  • 10 Department of Research, Canadian Memorial Chiropractic College, North York, ON, Canada
  • 11 Faculty of Medicine Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal, Toronto, ON, Canada
  • 12 Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana
  • 13 ARTES Spine Center, Acibadem University, Ankara, Turkey
  • 14 Concord Clinical School, University of Sydney, Concord, NSW, Australia
  • 15 Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
  • 16 World Spine Care, Tampa, FL, USA
  • 17 Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
  • 18 St. Michael's Hospital, North York, ON, Canada
  • 19 National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation, University of Complutense, Madrid, Madrid, Spain
  • 20 Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
  • 21 Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
  • 22 Department of Orthopaedic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, Western Cape, South Africa
  • 23 Palmer College of Chiropractic, Davenport, IA, USA
  • 24 Emergency Medicine, Carlsbad, CA, USA
  • 25 Department of Anesthesiology, University of Kansas, Medical Center, Kansas City, KS, USA
  • 26 College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
  • 27 Institut Franco-Européen de Chiropraxie, Toulouse, France
  • 28 U.S. Spine & Sport Foundation, San Diego, CA, USA
  • 29 ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
  • 30 Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
  • 31 Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
  • 32 Mahatma Gandhi Mission Institute of Health Sciences, MGM School of Physiotherapy, Navi Mumbai, Maharashtra, India
  • 33 Moi University/Moi Teaching & Referral Hospital, Eldoret, Kenya
  • 34 Law Society of Kenya, Nairobi, Kenya
  • 35 Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Center Region, Cameroon
  • 36 World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
  • 37 UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
  • 38 Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
  • 39 Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • 40 Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
  • 41 Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
  • 42 Department of Orthopedic Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA
  • 43 Sarawak General Hospital, Kuching, Sarawak, Malaysia
Eur Spine J, 2018 09;27(Suppl 6):901-914.
PMID: 30151811 DOI: 10.1007/s00586-018-5721-y

Abstract

PURPOSE: The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally.

METHODS: The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature. Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. An iterative consensus process was used.

RESULTS: After three rounds of review, 46 experts from 16 countries reached consensus for the care pathway that includes five decision steps: awareness, initial triage, provider assessment, interventions (e.g., non-invasive treatment; invasive treatment; psychological and social intervention; prevention and public health; specialty care and interprofessional management), and outcomes. The care pathway can be used to guide the management of patients with any spine-related concern (e.g., back and neck pain, deformity, spinal injury, neurological conditions, pathology, spinal diseases). The pathway is simple and can be incorporated into educational tools, decision-making trees, and electronic medical records.

CONCLUSION: A care pathway for the management of individuals presenting with spine-related concerns includes evidence-based recommendations to guide health care providers in the management of common spinal disorders. The proposed pathway is person-centered and evidence-based. The acceptability and utility of this care pathway will need to be evaluated in various communities, especially in low- and middle-income countries, with different cultural background and resources. These slides can be retrieved under Electronic Supplementary Material.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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