The AO Spine Knowledge Forums (KF) are AO Spine's flagship clinical study groups driving our evidence-based research. These five expert-driven working groups generate new knowledge in the spine pathologies of tumor, deformity, spinal cord injury, trauma, and degenerative disease.
The KF studies are designed to benefit surgeons in their daily work and to improve spine care globally. Thus, world-wide participation is encouraged and has increased considerably in recent years.
Looking behind the scenes, AO Spine Latin America talked with three surgeons from Latin America about their experiences in the KFs. Here, they also share their messages to aspiring spine surgeon researchers.
Andrei Joaquim, Brazil
AO Spine Knowledge Forum Trauma Associate Member
Two years ago, I received an invitation from Alex Vaccaro, the former KF Trauma Steering Committee Chairperson. I had already been involved in the AO Spine Injury Classification Systems as well as a proposal for treatment on upper cervical injuries.
It is a great experience from a personal and a professional perspective. Being involved with scientific spine leaders is a great chance to learn more and to become a better surgeon. Unfortunately, the COVID pandemic prevented us from in-person meetings, but I hope this will change soon.
The best part is the global participation, the different perspectives, experiences, as well as the friendly environment among the participants, combined with a high level of scientific expertise.
I have been involved in the post-traumatic deformity study evaluating the concepts involved in post-traumatic deformity, as well as the best evidence available on this theme. We are also involved in the validation of the Sacral, Cervical, and Upper Cervical Spine Injury Classification systems.
The cranio-cervical junction is my favorite area of study and this classification has the potential to simplify many old systems, helping surgeons in their decision-making, whether to perform surgery or not in the management of these complex injuries.
I think research is for those who like it. You should start with simple studies and associate yourself with more senior researchers. I believe that the key for research is "association"—you must learn from others, the Mentors—and one day, you realize you know how to delineate a study and how to write a paper by yourself.
"We should measure what we do in order to improve the quality of the treatment we offer to our patients."
With time, you will increase the complexity of your research, similarly as we grow as surgeons.
Unfortunately, research is not duly valued in less developed countries, which is why you must like it! It is important to have our own experience, as this may differ from that in developed countries.
Finally, if you do not question what you do, if you do not evaluate your treatments, you are not doing good medicine. As surgeons, we should question every day whether we are doing the right thing and evaluating our results. Even if we do not publish, we should measure what we do in order to improve the quality of the treatment we offer to our patients.
William Teixeira, Brazil
AO Spine Knowledge Forum Tumor Associate Member
My participation in a KF Tumor project started after the AO Spine Latin America Regional Courses with an invitation from Charles Fisher, the former KF Tumor Steering Committee Chairperson. He is a great encourager of our participation. Currently, we are involved in the Metastatic Tumor Research and Outcomes Network (MTRON) which is a prospective database on treatment outcomes of vertebral metastases.
Studies with vertebral metastasis are complex. The disease is very heterogeneous, which makes it challenging to produce good quality work in a single institution. Databases, such as MTRON, allow observing the results of different modalities of vertebral metastases treatments in various centers worldwide and generating hypotheses that will make possible the design of new studies to advance the quality of care for these patients.
What has brought the most satisfaction has been the support from AO and the training our team received to develop clinical research. Participating in the KF has been a very productive learning experience, how to conduct serious, high-quality clinical research. We hope that this will inspire others to invest time and effort in research for patients to benefit from technical advances over time.
"In addition to benefiting the entire society, research is an opportunity for personal growth."
Doing research is something that requires dedication and effort. In addition to benefiting the entire society, research is an opportunity for personal growth. There is a large community at AO Spine dedicated to encouraging new researchers. Clinical research courses, internships, and contact with other researchers is something that AO Spine can offer to those who want to dedicate themselves to research.
André Andujar, Brazil
AO Spine Knowledge Forum Deformity Associate Member
My initial contact to the KFs was in 2012 when I enrolled in the study, "An International Consensus on the Surgical Treatment Standards for Adolescent Idiopathic Scoliosis". Then, in 2017, I was invited to the KF Deformity as an Associate Member.
The work in the KFs is based on the collaboration of some of the most brilliant minds from all over the world with the goal to produce new knowledge. These studies are open for global collaboration, which makes them not only democratic but reflects the current real-world knowledge.
Some of these studies could not be done without the collaborative work of AO Spine; they brought these minds together with the aim to create knowledge that will change the behavior of any spine surgeon treating spinal deformities, to deliver better and safer care for the patients all over the world.
My hospital was chosen as an investigation site also for SDIM, a prospective observational study aimed at understanding the responses to neurophysiological events during surgeries of rigid and/or severe deformities.
This study will help us to create better protocols and improve safety for those surgeries.
Research means permanent study, and consequently, continuous learning. This makes us better doctors and improves the care for our patients. On the other hand, the more we study, the more we see how little we know, and that makes us more—and again more—humble.
"The more we study, the more we see how little we know, and that makes us more—and again more—humble."
For me, it is an honor and a special opportunity to be part of a group that includes some of the most renowned spine surgeons in the field of spine deformity. Here in Brazil, we do not have the same facilities and dedicated teams focused on research, so it has been a fantastic learning experience for me.
Being part of the KF gives my career immeasurable credibility! I am very proud to be a KF member and I hope to contribute much more to the near future.
Also, Emiliano Vialle from Brazil and Juan Pablo Cabrera from Chile are active in the KFs. Vialle has been involved from the early days and is currently a Steering Committee member of KF Trauma. Amongst other advantages, he says "the essential importance is the unique possibility of spreading the experience and ideas of Latin America equally with opinion leaders from all over the world."
Juan Pablo Cabrera is one of the youngest KF Degenerative Associate Members, since February 2021. Cabrera believes research should be part of every spine surgeon's career: "Research allows us to analyze our results and make important decisions based on more than intuition or previous experience."
The first step is to participate in AO Spine Knowledge Forum studies. Every open call can be a chance to let the study organizers know more about you and your interests. If you are an AO Spine member and have opted into receiving AO Spine emails, you will get information on all open calls.
Participating in AO Spine fellowship and mentorship programs will also allow you to work side-by-side with world-renowned spine surgeons and researchers and learn how to integrate research into your daily work.
AO PEER (AO Program for Education and Excellence in Research) is a collection of clinical research resources, reference documents, and learning opportunities, and can help you get started. It is specifically designed for health care professionals who want to learn or improve the skills needed to conduct clinical research.
