Corresponding Author

Alaaeldin Azmi Ahmad, MD

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Background Data: Pediatric spine deformity (PSD) represents a true challenge worldwide, a challenge that is significantly heightened in low- and middle-income countries (LMICs) due to health inequity and inequality based on political, ethnic, and socioeconomic status. As such, poor people in LMICs suffer from higher rates of illnesses and, thus, morbidity and mortality. Amidst the lack of global consensus on the treatment of PSD and the organizational and financial limitations in LMICs, we herein explore the challenges and provide a holistic management plan for PSD in these countries.

Purpose: This review aims to shed light on limitations in the delivery of care and provide a holistic management plan for PSD in areas with limited resources.

Study Design: This is a narrative review study.

Patients and Methods: The authors performed a review of peer-reviewed literature on PSD, trends, management, outcomes, and complications, in addition to a review of the challenges and limitations in care delivery in LMICs and experiences in dealing with the problem.

Results: The first step should be dedicated to clarifying the indications and identifying the surgical candidates. The choice of surgical technique should be in harmony with the patient’s deformity, affordability, resource availability, and surgical expertise. The management of PSD is possible in resource-limited countries if the proper preoperative optimization and evaluation, intraoperative care, and postoperative management are meticulously undertaken. Blended learning and technology have a role in the teaching and training of medical personnel. Governments should play central roles in collecting information, identifying the gaps, finding solutions to the PSD problem, and applying new reforms to the current system that facilitate delivery and improve the quality of care. Surgeons in LMICs should not limit themselves to traditional techniques but be versatile and cost-efficient.

Conclusion: A blueprint for an ideal healthcare system doesn’t exist yet. Success in strengthening healthcare systems is a long-term process that comes from improvising proper strategy and creating an environment supporting innovations. Experts in the treatment of PSD are available in LMICs and can provide services to the local population and innovate new ways to compensate for limited resources.


pediatric spine deformity; limited resources; low-income countries; holistic management; blended learning