Nowadays, the treatment of spinal disorders is one of the most controversial and challenging topics with its significant social, ethical, economic, and political impacts; the issues deriving from spinal disorder management, qualification of spine specialists and organization of best quality spine centers must be addressed.

However, there is no comprehensive spine education curriculum nor spine specialist certification or diploma in place; hence there is a lack of common ground between the multiple professions involved such as General Practitioners, Physiotherapists, Chiropractors, Rehabilitation specialists, Rheumatologists, Physiologists, Psychologists, Orthopedic surgeons and Neurosurgeons should be addressed. Only a few guidelines on patient management across the

different professions have been issued and are controversial because there is no benchmarking.

Therefore quality management processes are not sufficiently implemented at medical institution levels. In this environment, healthcare payers suffer from insufficient evidence and visibility to address objectively the real cost-benefits ratio and the safety & efficacy of currently available treatments and to promote the development of best quality spine centers.

Next: Patients and Associations