Background: Spinal tumors are neoplasms occurring in or around the spinal cord and can be classified based on tissue type and location within the spine. These lesions can lead to spinal cord compression and neurologic deficit. Low- and middle-income countries (LMICs) often face a significant burden of disease due to limited access to healthcare and advanced treatments. We investigate surgical and adjunctive therapies for spinal column tumors in LMICs. Methods: A systematic search was completed to identify articles related to spinal tumors in LMICs. Data were extracted for study parameters and patient outcomes. Country-specific variables were collected for each country. A pooled meta-analysis was completed with this data. Results: Of 99 included articles, 67 provided data on gross total resection (GTR), while 39 articles reported use of adjunctive therapies. Since 1990, there has been an increase in the use of both treatments in LMICs; however, there were significant correlations between the use of adjunctive therapy, life expectancy, and access to healthcare. Conclusion: While treatment and outcomes of spinal column tumors vary within the United States based on socioeconomic factors, including income and gender, this has not been studied on a global scale and in relation to accessibility of specific treatments in LMICs. In this study, we found that specific diagnoses and country income levels were significant drivers of GTR or adjunctive therapy rates. The poor accessibility of these treatments may be overcome with targeted investment, and this should be explored in future research.

Background: Minimally invasive spine surgery (MISS) has become increasingly common, but there are barriers to its adoption in acute trauma. To investigate these barriers, clinical data on preoperative factors and outcomes were compared between patients undergoing percutaneous and open spinal trauma procedures. Methods: In this retrospective cohort study of the National Trauma Data Bank, we analyzed trauma patients nationwide who underwent spine procedures from 2017 to 2023. Using International Classification of Diseases, Tenth Revision codes, index procedures classified as “open”, “percutaneous/MISS”, or “converted.” Comorbidities, demographic data, and adverse events were analyzed and compared between groups. Results: Of the 187,382 patients included, 13.2% underwent MISS. Open surgery correlated with males, older patients, and major comorbidities, including diabetes mellitus, congestive heart failure, and chronic obstructive pulmonary disease. MISS correlated with smoking and greater injury severity. Except for surgical site infections, all adverse events were more prevalent following open procedures. Conclusion: From 2017 to 2023, traumatic spinal surgery increased significantly, and the percentage approached percutaneously procedures increased from 11.7% to 15.2%, while adverse events were more common after open surgery.