Evidence-based spine surgery - The twilight of a myth

The cost of spine surgery care has been rising for decades. For this reason, the need for efficiency and quality control has increased significantly. Evidence-based medicine is a scientific method that seeks connections between medical theory and clinical practice to improve health care decisions. It is the only scientific tool used to improve the quality of medical practice. Our publication examines the impact of evidence-based medicine on spine surgery. Evidencebased medicine primarily defines evidence based on population-based randomized clinical trials or systematic literature reviews. However, spine surgery has a long tradition of empirical, experience-based treatments, so innovation and therapeutic development were not based on randomized clinical trials. From the perspective of spine surgery, evidence-based medicine is an authoritarian system that stems from the dominance of healthcare funders and has resulted in the disappearance of innovation in spine surgery. It relegated individual medical judgment to the background. The system is unable to renew itself and serve the development of spine surgery. From the patients' point of view, the standardization of spine surgery care is neither desirable nor possible.