Title : Straightening the system: Rethinking spine care through multidisciplinary teams
Abstract:
Care for patients with spinal deformity is frequently fragmented across multiple specialists, which can delay diagnosis, complicate communication, and produce inconsistent treatment decisions. Multidisciplinary spine clinics have been proposed to address these challenges by bringing key providers together in a coordinated setting. This narrative review synthesizes recent literature comparing multidisciplinary models with traditional fragmented approaches across the full spectrum of spine care, from surgical decision-making through psychosocial support, within the current context of AI-assisted decision support, value-based reimbursement reform, and evolving Enhanced Recovery After Surgery (ERAS) protocols.
Integrated clinics are consistently associated with more coordinated, consensus-driven decision-making and earlier access to both conservative treatment and surgical evaluation. Several studies report lower complication and reoperation rates in multidisciplinary settings, although the evidence is predominantly observational and findings vary by patient population, institutional infrastructure, and case-mix. Patient-reported measures of pain, function, satisfaction, and quality of life are generally similar or modestly improved compared with fragmented care, while practical advantages include shorter wait times for imaging, improved provider-to-provider communication, and more efficient preoperative preparation.
Emerging tools such as machine learning-based outcome prediction and automated imaging analysis show promise for risk stratification and deformity quantification, though concerns about model interpretability, generalizability, and bias in underrepresented populations remain important limitations. Bundled payments and other value-based reimbursement models are highlighted as policy levers that align incentives across surgical, rehabilitative, and post-acute care providers and may help sustain and expand multidisciplinary programs.
Persistent barriers, including infrastructure demands, reimbursement structures, scheduling complexity, and inequitable access related to geography, insurance status, and socioeconomic factors, continue to limit broader adoption and disproportionately affect underserved populations. This review provides an actionable framework for institutions seeking to implement or expand integrated spine care and identifies priority areas for future investigation, including prospective multicenter studies, rigorous health economic analyses, and equity-focused implementation research. Expanding access to multidisciplinary spine care, supported by digital health tools and thoughtful policy reform, represents a meaningful opportunity to improve outcomes for patients with spinal deformity across diverse clinical settings.
