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Eur Spine J. 2018 Sep;27(Suppl 6):838-850. doi: 10.1007/s00586-018-5635-8. Epub 2018 Aug 11.

The Global Spine Care Initiative: public health and prevention interventions for common spine disorders in low- and middle-income communities.

Author information

1
Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
2
National University of Health Sciences, Lombard, IL, USA.
3
Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA. globalspinecareinitiative@gmail.com.
4
National University of Health Sciences, Lombard, IL, USA. globalspinecareinitiative@gmail.com.
5
Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
6
Department of Neurology, University of California, Irvine, Irvine, CA, USA.
7
World Spine Care, Santa Ana, CA, USA.
8
College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA.
9
Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA.
10
Emergency Medicine, Carlsbad, CA, USA.
11
National School of Occupational Medicine, Carlos III Institute of Health, Madrid, Spain.
12
Physical Medicine and Rehabilitation Department, University Complutense, Madrid, Spain.
13
Physical Medicine and Rehabilitation Section, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA.
14
Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, Tamilnadu, India.
15
Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA.
16
Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.
17
World Spine Care Europe, Holmfirth, UK.
18
Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.
19
UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada.

Abstract

PURPOSE:

The purpose of this study was to develop recommendations for prevention interventions for spinal disorders that could be delivered globally, but especially in underserved areas and in low- and middle-income countries.

METHODS:

We extracted risk factors, associations, and comorbidities of common spinal disorders (e.g., back and neck pain, spinal trauma, infection, developmental disorders) from a scoping review of meta-analyses and systematic reviews of clinical trials, cohort studies, case control studies, and cross-sectional studies. Categories were informed by the Global Spine Care Initiative (GSCI) classification system using the biopsychosocial model. Risk factors were clustered and mapped visually. Potential prevention interventions for individuals and communities were identified.

RESULTS:

Forty-one risk factors, 51 associations, and 39 comorbidities were extracted; some were associated with more than one disorder. Interventions were at primary, secondary, tertiary, and quaternary prevention levels. Public health-related actions included screening for osteopenia, avoiding exposure to certain substances associated with spinal disorders, insuring adequate dietary intake for vitamins and minerals, smoking cessation, weight management, injury prevention, adequate physical activity, and avoiding harmful clinical practices (e.g., over-medicalization).

CONCLUSION:

Prevention principles and health promotion strategies were identified that were incorporated in the GSCI care pathway. Interventions should encourage healthy behaviors of individuals and promote public health interventions that are most likely to optimize physical and psychosocial health targeting the unique characteristics of each community. Prevention interventions that are implemented in medically underserved areas should be based upon best evidence, resource availability, and selected through group decision-making processes by individuals and the community. These slides can be retrieved under Electronic Supplementary Material.

KEYWORDS:

Epidemiology; Health promotion; Risk factors; Spinal diseases

PMID:
30099669
DOI:
10.1007/s00586-018-5635-8

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