Dear Colleagues,
Spine surgery in Türkiye has undergone a remarkable evolution over the past two decades. Increasing surgical volume, expanding subspecialization, and broader access to advanced instrumentation have positioned Turkish spine surgeons as active contributors to regional and international practice. However, as the discipline matures, it faces a critical transition: moving from experience-driven practice to a more standardized, data-oriented, and outcome-focused model of care.
One of the defining characteristics of spine surgery in Türkiye is its high clinical exposure. Surgeons frequently manage complex degenerative conditions, trauma, deformity, and revision cases, often at volumes exceeding those of many comparable healthcare systems. This experience constitutes a significant strength. Yet, high case volume alone does not automatically translate into high-quality evidence. The systematic collection of prospective data, the use of standardized outcome measures, and long-term follow-up remain inconsistent across institutions. Strengthening national registries and multicenter collaborations should therefore be viewed not as an academic luxury but as a clinical necessity.
Another important challenge lies in the variability of practice patterns. Differences in surgical indications, technique selection, and perioperative management are observed not only between institutions but also within the same center. While individual judgment remains central to surgical decision-making, excessive variability can obscure best practices and hinder meaningful comparison of outcomes. Developing consensus-based national guidelines-adapted to local resources and patient characteristics-would help align care while preserving clinical autonomy.
Technological adoption presents both opportunity and responsibility. Advanced spinal implants, navigation systems, and minimally invasive techniques are increasingly available in Türkiye, particularly in tertiary centers. However, access remains uneven, and structured training pathways are not always standardized. The rapid diffusion of technology without parallel emphasis on indications, learning curves, and cost-effectiveness risks widening disparities and compromising patient safety. A deliberate, education-centered approach to innovation-supported by national societies and academic institutions-is essential.
Spine surgery training also warrants renewed attention. While residency and fellowship programs provide strong foundational skills, the expanding complexity of modern spine care demands ongoing professional development. Topics such as outcome interpretation, complication management, shared decision-making, and interdisciplinary collaboration should be integrated more formally into training curricula. Furthermore, nurturing a research-oriented mindset among young surgeons is critical for sustaining academic productivity and clinical advancement.
Patient expectations in Türkiye are also evolving. Increased access to information, heightened awareness of surgical alternatives, and growing emphasis on quality-of-life outcomes require surgeons to communicate more transparently and engage patients as active partners in care. Incorporating patient-reported outcome measures into routine practice would not only improve clinical insight but also strengthen trust and accountability.
Finally, spine surgery in Türkiye must continue to define its role within the broader healthcare system. As spinal disorders place an increasing burden on working-age and elderly populations, surgeons have a responsibility to advocate for evidence-based care pathways that balance effectiveness, safety, and sustainability. Collaboration with policymakers, rehabilitation specialists, and primary care providers will be essential to achieving this goal.
In conclusion, spine surgery in Türkiye stands at a decisive moment. By transforming extensive clinical experience into structured knowledge, embracing standardization without rigidity, and prioritizing education and data-driven practice, the Turkish spine community can shape a future defined not only by technical excellence, but by measurable, meaningful patient outcomes.
Co-Editor-in-Chief
Ömer Erşen, M.D.,
