# SPINE20 recommendations 2025: Sustainable spine care for all

## TL;DR

This paper outlines global recommendations for sustainable spine care, aiming to reduce disability and improve health policies in G20 countries.

## Contribution

The paper introduces a comprehensive policy framework for spine care, emphasizing sustainability and global collaboration.

## Key findings

- Spine disorders affect over 900 million people globally, causing significant disability.
- SPINE20 proposes integrating spine health into public health and primary care systems.
- Public-private partnerships and registries are recommended to improve spine care outcomes.

## Abstract

Spine disorders remain a leading cause of disability worldwide, affecting over 900 million people and creating profound social and economic burden. In response, SPINE20, a global alliance of 38 professional societies, presents its 2025 policy recommendations under the theme “Sustainable Spine Care for All”.

Main recommendation; SPINE20 recommends G20 countries to implement sustainable evidence-based spine care models drawing on successful global programs considering particularly registries, incentivized health targets and public-private partnerships.

Focused on “Public health”; SPINE20 recommends G20 countries to integrate spine health into public health and primary care health policies by addressing the prevention and management of both communicable and non-communicable diseases, and strengthening public–private partnerships to achieve sustainable spine care.

Focused on “Occupational Health & Safety Policy”; SPINE20 recommends that G20 countries implement evidence-informed, work-focused interventions that address employee and workforce factors early, to reduce the social and economic impact of work loss and increase employability for people with spine disorders.

Focused on “Capacity Building”; SPINE20 recommends that G20 countries prioritize building capacity in spinal cord injury care by adopting evidence-based interventions such as the global initiatives supported by World Health Organization (WHO) in low- and middle-income countries and aligned with the WHO Rehabilitation 2030 Call to Action.

This paper serves as a summary of the recommendations. The complete set of SPINE20 2025 Recommendations, which is available in SPINE20 official web-site (https://spine20.net), was officially presented to Provincial Minister of Health and Wellness, Western Cape Government, during the SPINE20 Summit 2025. An official communication from the Western Cape Ministry of Health and Wellness subsequently confirmed formal acknowledgment of receipt of the recommendations.

•SPINE20 recommends G20 to adopt sustainable, evidence-based spine care models.•Integrate spine health into public health, primary care, and prevention systems.•Implement work-focused interventions to reduce disability and improve employability.•Build national capacity for spinal cord injury care aligned with WHO initiatives.•Promote registries, public-private partnerships, and outcome-based health targets.

SPINE20 recommends G20 to adopt sustainable, evidence-based spine care models.

Integrate spine health into public health, primary care, and prevention systems.

Implement work-focused interventions to reduce disability and improve employability.

Build national capacity for spinal cord injury care aligned with WHO initiatives.

Promote registries, public-private partnerships, and outcome-based health targets.