Mapping healthcare services and practice variations in spinal care across countries: The Spine Atlas Initiative.

Introduction: Inspired by cancer registration, the Spine Atlas Initiative (SAI) aims to create a global, standardised framework for mapping spine care services and treatment variations across countries. This initiative seeks to improve understanding of spine pathology trends and treatment patterns internationally. Research question: How can a standardised international data collection and visualisation framework enhance the understanding of spine care variations and inform healthcare practices? Material and methods: The SAI will conduct international data calls, focusing on specific spinal pathologies, beginning with lumbar degenerative spondylolisthesis (LDS) in 2025. Participants, including hospitals, registries, and practitioners, will report 7 mandatory and 7 optional data parameters. Data will be collected through templates, the Spine Tango platform, or existing registry formats. Data quality and representativeness will be strictly evaluated to ensure comparability across regions. Results: The 2025 LDS data call has attracted over 280 surgeons from 50 countries, which expressed their interest to participate. The collected data will provide valuable insights into variations in LDS treatment practices and outcomes across different regions. Discussion and conclusion: The SAI offers a collaborative, low-barrier approach to data collection, providing a platform for international research and comparison. The initiative will enhance understanding of treatment variability and outcomes, foster evidence-based improvements in clinical practice, and guide healthcare policy. Future data calls will expand to cover other spinal pathologies and non-surgical treatments, contributing to a global research network and improving spine care worldwide.