Section Spotlight
An Innovative Approach to Spine Trauma Care in Low- and Middle-Income Countries
David Gendelberg, MD
University of California, San Francisco Orthopedic Trauma Institute San Francisco, CA
Michael F. Coscia, MD
Director, SIGN Spine Care Zionsville, IN
Ashraf N. El Naga, MD
University of California, San Francisco Orthopedic Trauma Institute San Francisco, CA
David Gendelberg, MD, previews this article on an innovative approach to spine care in low- and middle-income countries.
The Challenge
The prevalence and consequences of traumatic spine injuries in low- and middle-income countries (LMICs) is undeniable.
When considering addressing such a challenge, several major concerns arise, including:
- Can technically challenging spinal surgery be safely performed in LMICs?
- Will infection and routine complication rates be prohibitive?
- Is adequate competent anesthesia and postoperative rehabilitation available in such circumstances?
- Is long term follow-up of patients possible?
- Who will cover the cost of the instrumentation/implants?
- Will the economic costs to the involved patients’ families and their national health care systems be reasonably balanced with patients’ recovery and functional return to society post-operatively?
- How do we move from isolated medical missions to sustainable clinical, educational, and research collaborations?
Past Successful Models
The SIGN Fracture Care International organization (a 501c3 nonprofit) was created to address the treatment of long bone fractures in LMICs through providing education and implants not requiring intraoperative radiography or electricity. SIGN (https://www.signfracturecare.org) began 26 years ago, as an all-inclusive orthopaedic education and treatment effort by Dr. Lewis Zirkle. The initial goal of SIGN was to address the treatment of long bone fractures in LMICs without the need for intra-operative radiography or power tools.
8th annual MOI Trauma course in collaboration with UCSF and SIGN.