Defining Appropriate Spine Care for the Patient as well as Society

In this era of constrained resources, spine care professionals are challenged to provide value and justification of resource allocation. For surgeons, this requires demonstration of clinical superiority that is both significant and durable compared with nonsurgical management and/or with other forms of surgical treatment. Value concepts such as the cost per quality-adjusted life year allow for more objective comparisons of treatment both for the same condition and for different conditions across a variety of disciplines. It thus becomes imperative that these concepts are learned and used in the design of future studies in the treatment of spinal disorders.