Spine Surgery in Europe: Status Quo? Haluk Berk M.D.

UEMS-MJC on Spine 16 th of September 2011, Brussels Participants – Robert Gunzburg – Wilco PeulEANS – Haluk BerkEBOT – Tamas İlles(apologies) – Max Aebi – Finn Christensen – Representative from (Interventional) Neuroradiology – Bernard Maillet

Robert GunzburgChair Wilco PeulSecretary Next meeting – 6 th of January, :00 Brussels. –

Methods Spine Society Presidents – 14/25 s to members of SSE and other spine societies – 203/845 responded

National spine societies Austria Belgium Czech Republic Denmark France Italy The Netherlands Rep of Ireland Spain Sweden Turkey UK n members Total Ortho spine 1 Neuro spine 12 Mixed society

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2-Cervical spine injury 4-Pediatric Spinal deformity 6-Spinal tumours (extradural) 8-Cervical disc herniation 10-Cervical Spine arthroplasty procedures 12-Lumbar Spinal stenosis

A-Do you think a subspecialty period of one year should be considered in order to provide a certification of competence in a given subspecialty? B-Do you think a combined spine fellowship should be offered? C-Do you think the EFORT should develop a spine subspecialty-training program and fellowships? D-Do you think the Eurospine-SSE should develop a spine subspecialty-training program and fellowships? E-Do you think the EANS should develop a spine subspecialty-training program and fellowships? F-Do you think there is a need for spine subspecialty training in neurosurgery/orthopaedic surgery?

Survey 2 Female7 Male187 Neurosurgeon 56 Orthopaedic surgeon 97 Spine surgeon 41 Age – <301 – – – – >6021

Who does, what?

Cervical disc herniation (ACDF)7,616,14 Cervical spinal stenosis7,556,09 Anterior cervical stabilization techniques?7,856,47 Cervical disc herniation minimally invasive/endoscopic techniques?4,283,60 Lumbar disc herniation8,717,89 Lumbar disc herniation minimally invasive/endoscopic techniques?6,375,43 Lumbar spinal stenosis9,008,31 Extradural tumour surgery?7,386,08 Intradural tumour surgery?4,443,64 Spinal deformity techniques (kyphosis, scoliosis)?7,086,44 Emergency management of cervical spinal trauma?7,475,81 Posterior cervical stabilization techniques?7,566,28 Craniocervical stabilization techniques?6,895,36 Emergency management of thoracic and lumbar spinal trauma?8,286,95 Posterior thoracic and lumbar stabilization techniques?9,088,58 Anterior thoracic and lumbar stabilization techniques?7,756,61 Anterior thoracic and lumbar stabilization minimally invasive/endoscopic techniques?5,024,27 Spinal Injections7,045,59 Interspinous devices6,483,81 Dynamic stabilization techniques6,644,33 IDET, Nucleotomy procedures4,182,41 How competatnt are you in? How important is it for you?

AvSD Do you think a subspecialty period of one year (after completion of the current 5–6 year national neurosurgeryWho does, what?/orthopaedics training programs) should be considered in order to provide a certification of competence in a given subspecialty? 6,983,13 Would you personally be interested in a subspecialty spine fellowship-training program (minimum 1 year)? 5,383,78 Do you think a combined (neurosurgery and orthopaedic) spine fellowship should be offered? 8,502,28 Do you think the Eurospine-The Spine Society of Europe should develop a spine subspecialty-training program and fellowships? 8,392,29 Do you think EANS-European Association of Neurosurgical societies should develop a spine subspecialty-training program and fellowships? 6,043,39 Do you think EFORT-European Federation of Orthopaedics and Traumatology should develop a spine subspecialty-training program and fellowships? 5,743,49 Do you think there is a need for spine subspecialty training in neurosurgery/orthopaedic surgery? 9,061,80

Conclusion ??? There is a tendency towards spine sub- speciality.