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

PURPOSE: 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. METHODS: 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. RESULTS: 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 SPINE20.org website and during the virtual inaugural meeting November 10-11, 2020 held from the G20 platform. CONCLUSIONS: 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

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

Purpose 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. Methods 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. Results 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 SPINE20.org website and during the virtual inaugural meeting November 10-11, 2020 held from the G20 platform. Conclusions 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

Aggressive L3 vertebral hemangioma coexisting with adult thoracolumbar scoliosis: Case report

Vertebral hemangiomas are benign vascular tumors that are commonly asymptomatic. A low percentage might become aggressive; however, they are not known to be associated with scoliosis. We present a case of a third lumbar vertebral lesion coexisting with a moderate thoracolumbar scoliosis. The patient's initial presentation was back pain with bilateral lower limb radiculopathy and neurogenic claudication. Diagnosis was established using CT and MRI, which showed classical findings of an aggressive vertebral hemangioma. The patient underwent Partial hemangioma excision and scoliosis correction, with satisfactory outcome at 1 year follow up

Traumatic spinopelvic dissociation: A case series

Introduction: Spinopelvic dissociation was described first in 1969. It is an injury characterized by the separation of the lumbar spine, with parts of the sacrum, from the rest of the sacrum and pelvis with the appendicular skeleton through the sacral ala. Spinopelvic dissociation has an incidence of approximately 2.9% of all pelvic disruptions and corresponds with high-energy trauma. The objective of this study was to review and analyze a case series of spinopelvic dissociations that were treated in our institution from May 2016 to December 2020. Methods: This was a retrospective study reviewing medical records of a series of cases with spinopelvic dissociating. A total of nine patients were encountered. Demographic data including gender and age were analyzed with the mechanism of injury, fracture characteristics, and classifications in addition to neurological deficits. Fractures were classified by the AO Spine Sacral Classification System. Moreover, neurological deficits were classified using the Gibbon's classification score. Finally, the Majeed score was utilized for the assessment of the functional outcome after the injury. Results: A total of nine patients with spinopelvic dissociation were encountered, seven males and two females. Seven patients were due to motor vehicle accidents, one patient was due to a suicidal attempt, and one patient was due to seizure. Four patients suffered from neurological deficits. One patient needed an intensive care unit admission. Spinopelvic fixation was done for all patients. One patient had surgical wound infection with wound dehiscence, one had infected instruments with confirmed spine osteomyelitis, and one had a focal neurological deficit. Six patients went on to heal and showed complete neurological improvements. Conclusion: Spinopelvic dissociation injuries represent a variety of injuries that are commonly associated with high-energy trauma. The triangular fixation method has proven to be a stable construct in dealing with such injuries

Consequences of neglected traumatic spinal cord injuries

الملخص: أهداف البحث: تسببت إصابات الحبل الشوكي بإعاقات كبيرة تعتبر أحداثا مدمرة ومحبطة لكل من المرضى ومقدمي الرعاية الصحية. معظم إصابات الحبل الشوكي الرضحية تنسب الى الحوادث المرورية. الإصابات المهملة تؤدي الى مضاعفات ونتائج سيئة. في هذا الدراسة نبحث في أسباب وعواقب ونتائج إصابات الحبل الشوكي الرضحية المهملة طرق البحث: تم إجراء هذه الدراسة في مدينة الملك عبد العزيز الطبية في الرياض، المملكة العربية السعودية. من بين ٧٥٠ مريضا تم علاجهم في الفترة بين فبراير ٢٠۱٦ الى فبراير ٢٠٢۱ استوفى ۱٨ مريضا معيار التضمين الخاص بالدراسة وهي إصابة رضحية عالية الطاقة للحبل الشوكي مصاحبة لعجز عصبي، مما استلزم تخل جراحي بعد۱٤ يوم أو أكثر من تاريخ الإصابة. النتائج: من بين ۱٨ مريضا يعانون من إصابات الحبل الشوكي الرضحية المهملة، كان ٧٢٫٢٪ منهم ذكور. كان متوسط عمر المرضى وقت الإصابة ۳٦٫٨ عاما، كان جميع المرضى يعانون من إصابات في النخاع الشوكي ناتجة عن حوادث مرورية، وكان ٧٧٫٨٪ من خارج مدينة الرياض والتي تعزى الى تأخر الإحالة الى مركز ثلاثي متخصص عند معظم الحالات (٨٨٫٩٪). بلغ متوسط مدة الإهمال ٤۳ يوما، واطولها ۱٢٥ يوما. كان أكثر مواقع الإصابة شيوعا هو منطقة الصدر القطني (٥٥٫٥٪). تحسن لدى ٢ من المرضى مقياس الضعف بناء على مقياس جمعية إصابات العمود الفقري الأمريكية. حدثت تقرحات الفراش لدى ٥٥٫٥٪ وتجلط الأوردة العميقة في ٢٧٫٨٪ من المرضى. بعد الجراحة، احتاج ٧٧٪ من المرضى الى دخول العناية المركزة. لم يتلق معظم المرضى (۱٢) تأهيل متخصص لإصابات النخاع الشوكي بعد الجراحة الاستنتاجات: الإحالة المبكرة للمرضى الذين يعانون من إصابات الحبل الشوكي الرضحية ضرورية لمنع المضاعفات القصيرة والطويلة -الأجل. Abstract: Objectives: Spinal cord injuries cause major disabilities and are devastating events for both patients and healthcare providers. Most traumatic spinal cord injuries (TSCIs) are due to motor vehicle accidents (MVAs). Neglected injuries result in complications and poor outcomes. Here, we investigated the causes, consequences, and outcomes of neglected TSCIs. Methods: This case series study was performed at King Abdulaziz Medical City, Riyadh, KSA. Of the 750 patients treated between February 2016 and February 2021, 18 patients met our inclusion criterion of neglected high-energy TSCI with neurological deficit, necessitating surgical intervention more than 14 days after the index trauma. Results: Of the 18 patients with neglected TSCIs, 72.2% were men. The patients’ mean age at the time of injury was 36.8 years, 77.8% were from outside Riyadh, and all patients had MVA-induced TSCIs, 88.9% of which were attributable to delayed referral to a tertiary center. The mean duration of neglect was 43 days, and the longest duration was 125 days. The most common site of injury was the thoracolumbar region (55.5%). The American Spinal Injury Association impairment scale score improved in two patients. Bed sores occurred in 55.5%, and deep vein thrombosis occurred in 27.8% of patients. Postoperatively, 77% of patients required intensive care unit admission. Most patients (12) did not receive specialized spinal cord injury rehabilitation postoperatively. Conclusion: Early referral of patients with TSCIs is crucial to prevent short- and long-term complications