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Obstacles to Spine Surgery in Limited-Resource Environments
Amer Sebaaly1, Mohammad Daher1,2, Joseph E Nassar2
1Department of Orthopedic Surgery, Hotel Dieu de France Hospital, Beirut, Lebanon.
The Journal of Bone and Joint Surgery. American Volume
|December 15, 2025
Summary
Spine surgery training in low-resource settings is hindered by limited resources and case exposure. Enhancing training requires global collaboration, cost-effective practices, and research capacity building for better patient outcomes.
Area of Science:
- Orthopaedic Surgery
- Global Health
- Medical Education
Background:
- Spine surgery in limited-resource environments faces challenges including high implant costs and lack of advanced technology.
- Residents in low- to middle-income countries (LMICs) experience inadequate training due to limited case exposure and faculty shortages.
Purpose of the Study:
- To identify challenges in spine surgery training and care within limited-resource settings.
- To propose strategies for improving surgical education and patient outcomes in these regions.
Main Methods:
- Literature review and synthesis of existing challenges and proposed solutions.
- Analysis of factors affecting surgical training, technology access, and research capacity in LMICs.
Main Results:
- Incomplete training, restricted access to essential technologies (e.g., intraoperative neuromonitoring, robotics), and limited research output are significant issues.
- International fellowships, telesurgery, global collaboration, cost-effective practices, and clinical guidelines can mediate these challenges.
Conclusions:
- Addressing the gaps in spine surgery requires a multi-faceted approach including enhanced global collaboration and capacity building.
- Implementing cost-effective strategies and fostering research are crucial for advancing spine care in LMICs.
