The spine : so many areas left to explore !

Published online: Dec 27 2014


From Clinique Saint Pierre, Ottignies Louvain-la-Neuve, Belgium


The papers that we put together in this issue of Acta Orthopaedica Belgica are all about spine. This is probably the field in Orthopaedic Surgery where most of unresolved problems remain. Many treatments have still unreliable results, at least when compared to what we are accustomed to, for example in hip or knee arthroplasty. Hence, the payers and even public opinion question the validity of many procedures in spinal surgery, in particular regarding degenerative conditions of the spine whereas it appears that close to 80% of surgical procedure in the spine are performed for degenerative pathologies. This ranges from the very common disc hernia to the complex degenerative deformities associated with stenosis and mechanical instability. Even for simple disk hernia the optimal management is still discussed! From pathogenesis to outcome assessment, we are still struggling with a number of unanswered questions : Why does it happen ? What do we want to treat ? When to do it ? Who to treat ? How to do it ? and Now… did our treatments reached the expectations of the patient ? Only research, critical analysis of treatments and outcome studies will help to progress. These can be very ambitious prospective randomized controlled studies, fundamental research, modest case reviews, or reporting on day-to-day registration of treatment with unbiased patient reported outcome assessment. The Spine Society of Belgium (SSBe) units, under one umbrella, orthopaedic surgeons, neurosurgeons, and physiotherapists from both French and Flemish speaking parts of the country involved in the care of back patients. We have chosen to participate to the Spine Tango Registry. This is an international database allowing for the registration of treatments – surgical and conservative – of spinal ailments, sponsored by Eurospine, the Spine Society of Europe. Doing so, our daily work becomes little stones to the building of knowledge about spinal pathology. All bits and pieces of knowledge will finally help to improve the care we give to our patients, as long as we remain aware of the limitations and value of each contribution and subsequent publication. Sharing some of this knowledge is the aim of Acta Orthopaedica Belgica.