Global Priorities and Knowledge Gaps in Spinal Trauma, Infection, and Osteoporotic Fractures: Insights From the AO...

Study DesignCross-sectional survey study.ObjectivesTo identify clinical knowledge gaps in spinal trauma and infection and assess use of AO Spine tools and recommendations.MethodsA 33-item online survey was distributed to AO Spine members by email and nonmembers through social media. Responses addressed demographics, case volume, knowledge gaps, and preferred educational formats. Descriptive statistics and regional comparisons using chi-squared or Fisher's exact tests were performed. Signficance was at the P < 0.05 level.ResultsOf 431 respondents, 412 completed at least one survey section and were included; the overall response rate could not be determined because the number of individuals who received or viewed the survey invitation was unavailable. Most respondents were orthopedic (61.2%) or neurosurgical (35.4%) surgeons. Leading priorities were osteoporotic spinal fractures (49.0%), spinal infection (48.3%), and fragility-associated low-energy sacropelvic fractures (40.3%). Regional variation was significant for sacropelvic fragility fractures (P = 0.038) and osteoporotic fractures (P = 0.028). Key gaps included bone quality optimization and surgical treatment for sacropelvic fragility fractures, comparison of techniques for osteoporotic fractures, and spinal infection algorithms. AO Spine Injury Classifications were routinely used by 89.5% of respondents. Use of the separate AO Spine-DGOU Osteoporotic Fracture Classification and AO Spine Primary Spine Infection Classification was reported by 35.7% and 18.7%, respectively, while PROST and CROST use was reported by 17.4% and 14.5%.ConclusionsSurgeons reported a need for standardized, evidence-based algorithms and accessible educational resources for osteoporotic fractures, spinal infection, and fragility-associated low-energy sacropelvic fractures.