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

Scott Haldeman, Claire D. Johnson, Roger Chou, Margareta Nordin, Pierre Côté, Eric L. Hurwitz, Bart N. Green, Christine Cedraschi, Emre Acaroğlu, Deborah Kopansky-Giles, Arthur Ameis, Afua Adjei-Kwayisi, Selim Ayhan, Fiona Blyth, David Borenstein, O’Dane Brady, Peter Brooks, Connie Camilleri, Juan M. Castellote, Michael B. Clay, Fereydoun Davatchi, Robert Dunn, Christine Goertz, Erin A. Griffith, Maria Hondras, Edward J. Kane, Nadège Lemeunier, John Mayer, Tiro Mmopelwa, Michael Modic, Jean Moss, Rajani Mullerpatan, Elijah Muteti, Lillian Mwaniki, Madeleine Ngandeu-Singwe, Geoff Outerbridge, Kristi Randhawa, Heather Shearer, Erkin Sönmez, Carlos Torres, Paola Torres, Leslie Verville, Adriaan Vlok, William Watters, Chung Chek Wong, Hainan Yu

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