Beyond the Limits to Become a Leading Force in Global Spine Surgery: Present and Future of Spine Surgery in Asia-Pacific
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* Seok Woo Kim

Home to 60% of the world’s total population and 70% of the world’s populous cities, the Asia-Pacific region remains the world’s fastest-growing economic powerhouse. This region has emerged as a major player in the field of spinal surgery, and its growing population, improving health care standards, international collaboration, and cost-effective treatment options make it an attractive destination for patients seeking spinal surgery.

The Asia-Pacific region has also been a hot spot for the adoption and utilization of new surgical techniques, including minimally invasive surgery and endoscopic surgery. A global survey found that Asian surgeons (96.7%) perform minimally invasive surgery and endoscopic surgery at a significantly higher rate than non-Asian surgeons (81.6%).1 Notably, surgeons in North America reported the lowest minimally invasive surgery/endoscopic surgery implementation rate globally at 62.8%.1 

This issue of the *International Journal of Spine Surgery* (*IJSS*) focuses on the Asia-Pacific region and contains many studies that demonstrate the substantial advancement of spine surgery in this region. From simple disc surgery to complex deformity surgery and tumors, the variety of reports included herein documents the latest treatment methods known in almost all areas of spine surgery today. In addition, there are outstanding articles that provide new ideas for future treatment methods or research beyond the current treatment trends. These contributions allow us to measure how the region has contributed to global spine surgery through active research, education, training, and international exchange beyond the regional limitations of the past. In particular, studies that expand the scope of endoscopic surgery from simple discectomy to fusion and challenging tumor surgery question or confront the stereotypes of contemporary disc surgery, and efforts to routinely perform deformity surgery using robotic and navigation surgery provide a glimpse into the future of deformity surgery. Additionally, studies that compare and contrast various fusion methods are very meaningful in terms of the strengths and weaknesses of current spine surgery and areas for potential improvement. This focused issue of *IJSS* provides the reader with an opportunity not only to view the reality of spine surgery in the Asia-Pacific region but also to demonstrate the development and potential of this region in global spine surgery.

I believe that the international engagement of the International Society for the Advancement of Spine Surgery (ISASS) has played a significant role in the background of this excellent focused issue. I would like to express my gratitude to the numerous researchers who contributed their work; to the reviewers who shared their knowledge that enhanced the quality of the manuscripts; to Audrey Lusher, the *IJSS* managing editor, who shared her passion and effort to compile this issue; to Charles Branch, the *IJSS* editor in chief, for inviting me to serve as a guest editor of this focused issue; and to the ISASS Past-Presidents Michael Wang and Huilin Yang and the current ISASS Presidents Morgan Lorio and Matthew Scott-Young, who helped make this entire process possible.

## Footnotes

*    **Funding**  The author received no financial support for the research, authorship, and/or publication of this article.

*    **Declaration of Conflicting Interests**  The author reports no conflicts of interest in this work.

*    **Editor's note**  Dr Kim served as the guest editor for this issue, which focuses on spine surgery research from the Asia-Pacific region.

*   This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2024 ISASS. To see more or order reprints or permissions, see [http://ijssurgery.com](http://ijssurgery.com).

## References

1.  1. Lewandrowski K-U , Soriano-Sánchez J-A , Zhang X , et al . Regional variations in acceptance, and utilization of minimally invasive spinal surgery techniques among spine surgeons: results of a global survey. J Spine Surg. 2020;6(Suppl 1):S260–S274. doi:10.21037/jss.2019.09.31 
    
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