Research surveys

Purpose: Provide insights that can be used to improve the education and training of surgeons worldwide, and to ensure that they are equipped to effectively use technology-assisted techniques to improve patient outcomes and advance the field of spine surgery.

Release date: February 2025

Target community: International

Principal Coordinating Investigator: Siegmund Lang

Co-Principal Coordinating Investigators:

Outcomes: -

Purpose: To create a structure for a consensus study, solidify best practices regarding spinal metastases, and establish guidelines to standardize their treatment.

Release date: January 2025

Target community: Regional, Europe

Principal Coordinating Investigator: Leevi Toivonen

Co-Principal Coordinating Investigators: Ahmed Shawky Abdelgawaad, Áron Lazáry

Outcomes: -

Purpose: AO Spine Knowledge Forum Trauma & Infection is seeking to understand the factors which influence surgeons’ treatment decisions in the management of high-energy thoracolumbar burst fractures (A3/A4) without neurologic deficit.

Release date: December 2024

Target community: International

Principal Coordinating Investigator: Sebastian Bigdon

Co-Principal Coordinating Investigators: Klaus Schnake, Gregory Schroeder

Outcomes:

Purpose: AO Spine Knowledge Forum SCI and myelopathy.org aim to gather perspectives on the most important symptoms and clinical signs of diagnosing degenerative cervical myelopathy (DCM). The results will help develop diagnostic criteria that will improve the identification of patients with DCM, resulting in earlier detection and better treatment outcomes.

Release date: November 2024

Target community: International

Principal Coordinating Investigator: Benjamin Davies

Co-Principal Coordinating Investigators: Michael Fehlings, Lindsay Tetreault

Outcomes:

Purpose: To investigate spine surgeons’ practices regarding opioid use prior to elective, instrumented spine surgery. The results of this survey will be used as a structure for a consensus study to help establish guidelines to standardize opioid use as a mechanism of pain management.

Release date: October 2024

Target community: International

Principal Coordinator Investigator: Dr. Zeeshan Sardar

Co-Principal Coordinating Investigators: Dr. Josephine Coury, Justin Reyes, Dionne Alexandra, Roy Miller, and Dr. Lawrence Lenke

Outcomes:

Purpose: To better understand the global variability in the intra- and postoperative management of patients undergoing spinal fusions.

Release date: March 2022

Target community: International

Principal Coordinating Investigator: Stephen Lewis

Co-Principal Coordinating Investigators: So Kato, Lawrence Lenke, Christopher Shaffrey, Tim Yoon, and Ho-Joong Kim

Outcomes: 

• Activity and sports resumption after long segment fusions to the pelvis for adult spinal deformity: survey results of AO Spine members
• Antibiotic Use in Adult Spine Deformity Surgery: Results From the AO Spine Surveillance of the Management of Patients With Adult Spine Deformity
• Surgeon Preferences Worldwide in Wound Drain Utilization in Open Lumbar Fusion Surgery for Degenerative Pathologies
• Post-operative bracing following adult spine deformity surgery: Results from the AO Spine surveillance of post-operative management of patients with adult spine deformity | PLOS ONE

Purpose: To gain insight into the practices and decision-making processes of surgeons in managing dural tears.

Release date: August 2024

Target community: International

Principal Coordinating Investigator: Sameh Abolfotouh

Co-Principal Coordinating Investigator: AO Spine Knowledge Forum Degenerative

Outcomes:

Purpose: AO Spine Knowledge Forum Degenerative seeks to understand preferences, challenges, and barriers with various anterior cervical spine surgical techniques and the factors influencing the choice of cervical fusion, disc arthroplasty, and hybrid procedures.

Release date: August 2024

Target community: International

Principal Coordinating Investigator: Philip Louie

Co-Principal Coordinating Investigators: Amit Jain, Zorica Buser, Samuel Cho, Daniel Riew, Tim Yoon

Outcomes:

Purpose: To understand the real-time experience of spine surgeons with and without various DVT prophylaxis measures to develop a best practice guideline and recommendation on VTE prophylaxis during posterior lumbar fusion surgeries.

Release date: June 2024

Target community: International

Principal Coordinating Investigator: Alexandro Dünki

Co-Principal Coordinating Investigators: Mazda Farshad, Andreas Demetriades, Sathish Muthu, Tim Yoon, AO Spine Knowledge Forum Degenerative

Outcomes:

Purpose: To identify key areas of improvement to steer further research, and enable better and earlier assessments of new medical interventions and technologies regarding perioperative processes related to instrumented degenerative spine surgery.

Release date: May 2024

Target community: International

Principal Coordinating Investigator: Hein Jonkman

Co-Principal Coordinating Investigators: Jorrit-Jan Verlaan, HD de Boer, TM Govers, SACA Debets, TW Wainwright, B Debono, MMH Yang, MM Rovers

Outcomes:

Purpose: AO Spine Knowledge Forum Degenerative seeks to understand the treatment strategies and preferences of spine surgeons for lumbar disc herniation.

Release date: May 2024

Target community: International

Principal Coordinating Investigator: Stipe Ćorluka

Co-Principal Coordinating Investigators: Luca Ambrosio, Gianluca Vadalà, Hans Jorg Meisel, Zorica Buser, Tim Yoon

Outcomes:

Purpose: To gather the perspective of spine surgeons on the 21st Century Cures Act that was introduced in the United States in 2016 and how the immediate accessibility to radiology reports impacts overall patient health.

Release date: April 2024

Target community: United States of America

Principal Coordinating Investigator: Khaled M. Kebaish

Co-Principal Coordinating Investigator: Andrew Kim

Outcomes:

Purpose: AO Spine Knowledge Forum Degenerative recently developed and published the AO Spine Guidelines for using Osteobiologics (AO-GO) in Anterior Cervical Discectomy and Fusion (ACDF) and aims to understand the practice patterns for the use of osteobiologics in ACDF and preferences for learning new technologies and guidelines.

Release date: March 2024

Target community: International

Principal Coordinating Investigator: Pieter-Paul Vergroesen

Co-Principal Coordinating Investigators: Sathish Muthu, Hans Jörg Meisel, Zorica Buser

Outcomes:

Purpose: To understand spine specialists’ attitudes and practice patterns towards osteoporosis and bone health screening, optimization and complications and establish an updated reference point for future studies of bone health optimization in spine surgery. It has been more than 15 years since the spine community last investigated these attitudes and practice patterns.

Release date: December 2023

Target community: International

Principal Coordinating Investigator: Yong Daniel Shen

Co-Principal Coordinating Investigator: Zeeshan Sardar

Outcomes:

Purpose: To assess the current landscape regarding the adoption of robotics in spine surgery.

Release date: November 2023

Target community: International

Principal Coordinating Investigator: Stefan Motov

Co-Principal Coordinating Investigator(s): Martin N. Stienen

Outcomes:

• Current state and future perspectives of spinal navigation and robotics—an AO spine survey

Purpose: AO Spine KF Tumor project analyzes the perceptions, opinions, and practices of spine surgeons about frailty regarding spine metastatic disease and identify what spine surgeons consider to be relevant preoperative factors and postoperative outcomes.

Release date: February 2021

Target community: International

Principal Coordinating Investigator: Michael Weber

Co-Principal Coordinating Investigators: Miltiadis Georgiopoulos, Raphaële Charest-Morin, Rory Goodwin

Outcomes: 

• Perception of frailty in spinal metastatic disease: international survey of the AO Spine community

Purpose: The AO Spine Knowledge Forum Spinal Cord Injury (KF SCI) seeks spine surgeons' input to understand the feasibility and utility of intraoperative ultrasound in managing SCI patients through a short survey.

Release date: December 2021

Target community: International

Principal Coordinating Investigator: James Guest

Co-Principal Coordinating Investigators: Christoph Hofstetter, Chris Neal

Purpose: AO Spine Knowledge Forum Spinal Cord Injury seeks spine surgeons' input to understand the current practice, including workup and follow up, for two key knowledge gaps in the care for DCM.

Release date: December 2021

Target Community: International

Principal Coordinating Investigator: James Harrop

Outcomes:

• Management of mild degenerative cervical myelopathy and asymptomatic spinal cord compression: an international survey

Purpose: To  estimate the prevalence of neck pain in spine surgeons by using different measures. As a secondary aim, the study will determine medical and professional consequences of neck pain and the associated factors as well as significant predictors of neck pain.

Release date: May 2021

Target community: International

Principal Coordinating Investigator: Sameh Abolfotouh

Outcomes:

• Epidemiology of Work-Related Neck Pain Among Spine Surgeons

Purpose: We are trying to understand how much or how little spine surgeons know about electromyogram and nerve conduction studies (EMG/NCS). This is a test of our community's knowledge.

For answers and explanations to the test questions, click here.

Release date: April 2021

Target community: International

Principal Coordinating Investigator: Daniel Riew

Outcomes:

• How Knowledgeable Are Spine Surgeons Regarding EMG-NCS for Cervical Spine Conditions? An International Aospine Survey

Purpose: In March 2020, during the first wave of the pandemic, an initial AO Spine COVID-19 survey was circulated to assess the impact of the virus on spine surgeons worldwide. One year later, we are interested in gaining more insight as to the longer-term follow-up of our community, addressing prediction models, as well as assessing unmet needs and expectations.

Release date: March 2021

Target community: International

Principal  Coordinating Investigator: Dino Samartzis

Co-Principal Coordinating Investigators: Philip Louie and the AO Spine Regional Research Officers

Outcomes:

• The Impact of COVID-19 Pandemic on Spine Surgeons Worldwide: A One Year Prospective Comparative Study

Purpose: To ascertain the degree of variability in management strategies of patients with spine metastasis across AO Spine members and determine what practice and training attributes best predict the management strategies employed by members

Release date: February 2021

Target community: International

Principal Coordinating Investigator: Daniel Sciubba

Co-Principal Coordinating Investigators: Larry Lo and Zach Pennington

Outcomes:

• International Variability in Spinal Metastasis Treatment: A Survey of the AO Spine Community

Purpose: To understand the current management preference of cervical SCI and obtain AO Spine members' input on a new classification system proposal for mild cervical SCI without instability

Release date: October 2020

Target community: International

Principal Coordinating Investigator: Jefferson R. Wilson, KF SCI member

Outcomes:

• A Practical Classification System for Acute Cervical Spinal Cord Injury Based on a Three-Phased Modified Delphi Process From the AO Spine Spinal Cord Injury Knowledge Forum

Purpose: To evaluate the demographic characteristics of spine surgeons and specific questions regarding the use of frailty indexes prior to elective spine surgeries

Release date: October 2020

Target community: Latin America

Principal investigator: Alfredo Guiroy

Outcomes:

• ¿Porqué los Índices de Fragilidad no son usados de manera sistemática en la consulta preoperatoria de Cirugía de Columna Vertebral?

Purpose: 
This survey seeks:
1) To assess the research capabilities and needs of the AO Spine community
2) To engage with AO Spine members and develop the strategic plan for how AO Spine can best support and develop research in the regions

Release date: September 2020

Target community: International

Principal Coordinating Investigator: Dino Samartzis

Outcomes: 

• Research Practices and Needs Among Spine Surgeons Worldwide

Purpose: To discuss the Clinical Practice Guidelines for the management of spinal disorders

Release date: August 2020

Target community: Latin America

Principal investigator: Asdrubal Falavigna

Outcomes:

• Knowledge, attitudes, and behaviors regarding the use of clinical practice guidelines among spine surgeons in Latin America

Purpose: Define the indications and techniques of spinal injection for treatment of lumbar degenerative spinal stenos more frequently used by spine surgeons in Latino America

Release date: June 2020

Target community: Latin America

Principal investigator: Marcelo Molina

Outcomes:

• Survey on Spinal Injections for lumbar degenerative stenosis among spine surgeons in Latin America

Purpose: 
This survey seeks to determine:
1) The extent of spine surgeon adoption of telemedicine
2) Surgeon satisfaction with telemedicine
3) Comparison of telemedicine to in-person visits
4) The use of telemedicine in training and research
5) Variations in perspectives and practices worldwide

Release date: May 2020

Target audience: International

Principal Coordinating Investigator: Sravisht Iyer

Outcomes: 

• Provider Confidence in the Telemedicine Spine Evaluation: Results from a Global Study
• Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study
• Telemedicine in research and training: spine surgeon perspectives and practices worldwide
• Telemedicine in Spine Surgery: Global Perspectives and Practices

Purpose: To assess the variability in the diagnosis of subaxial cervical facet injury, according to the AO Spine classification system, by spine surgeons in Latin America

Release date: May 2020

Target community: Latin America

Principal investigator: Juan Pablo Cabrera

Outcomes:

• CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?
  
  
• Accuracy and reliability of the AO Spine subaxial cervical spine classification system grading subaxial cervical facet injury morphology
  

Purpose: This survey addresses the impact that the COVID-19 virus has had on healthcare professional, in particular spine surgeons, and the inherent variations that may exist geographically and at different timepoints of virus severity upon society
Read more

Release date: March 2020

Target community: International

Principal Coordinating Investigator: Dino Samartzis

Outcomes:

•  The Impact of COVID-19 Pandemic on Spine Surgeons Worldwide
• Learning from the past: did experience with previous epidemics help mitigate the impact of COVID-19 among spine surgeons worldwide?
• Spine Surgery and COVID-19: The Influence of Practice Type on Preparedness, Response, and Economic Impact
• COVID‐19: Current and future challenges in spine care and education ‐ a worldwide study
• Personal Health of Spine Surgeons Can Impact Perceptions, Decision-Making and Healthcare Delivery During the COVID-19 Pandemic - A Worldwide Study
• COVID-19 and the Rise of Virtual Medicine in Spine Surgery: A Worldwide Study

Purpose: To analyze the variability in management and therapeutic alternatives in unilateral cervical facet joint dislocation without fracture in Latin America

Release date: March 2020

Target community: Latin America

Principal investigator: Andrei Joaquim

Outcomes:

• Management of Unilateral Cervical Facet Joint Dislocation in Neurologically Intact Patients: Results of an Ao Spine latin American Survey

Purpose: To evaluate access to the technologies necessary to perform those surgeries in Latin America.

Release date: February 2020

Target community: Latin America

Principal investigator: Alfredo Guiroy

Outcomes:

• Access to Technology and Education for the Development of Minimally Invasive Spine Surgery Techniques in Latin America 
• Neurosurgery versus orthopedic surgery: Who has better access to minimally invasive spinal technology?

Purpose: To identify gender-based differences within spine surgery, trying to identify factors that may influence male and female careers.

Release date: September 2019

Target community: Latin America

Principal investigator: Asdrubal Falavigna

Outcomes:

• Perception of gender discrimination among spine surgeons across Latin America: a web-based survey

Purpose: To describe the use, accessibility, and limitations of the intraoperative neuromonitoring in Latin America. See which countries have more difficulties on access and which pathologies surgeons believe neuromonitoring is more important in.

Release date: August 2019

Target community: Latin America

Principal investigator: Alfredo Guiroy

Outcomes:

• Barriers of neurophysiology monitoring in spine surgery: Latin America

Purpose: The objective of this survey is to assess the practices and variations towards anti-coagulation procedures of the international spine surgery community to establish future consensus and guidelines
Read more

Release date: May 2019

Target community: International

Principal Coordinating Investigator: Dino Samartzis

Outcomes: 

• Perioperative Anticoagulation Management in Spine Surgery: Initial Findings From the AO Spine Anticoagulation Global Survey
• Factors Affecting the Decision to Initiate Anticoagulation After Spine Surgery: Findings From the AOSpine Anticoagulation Global Initiative

Purpose: To evaluate the opinion and practices among spine surgeons on timing of decompression in patients with acute traumatic spinal cord injury.

Release date: March 2019

Target community: Latin America

Principal investigator: Asdrubal Falavigna and Alisson Telles

Outcomes: 

• Surgical timing in traumatic spinal cord injury: current practice and obstacles to early surgery in Latin America