¹Department of Neurosurgery, Klinikum Ibbenbueren, Ibbenbüren, Deutschland
²Department of Neurosurgery, Helios Klinikum Berlin-Buch, Berlin, Deutschland
³Department of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost, Department of Trauma, Hand and Reconstructive Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Deutschland
⁴Department of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost, Halle, Deutschland
⁵Department of Spine and Scoliosis Surgery, Lubinus Clinicum, Kiel, Deutschland
⁶Clinic for Spinal Surgery, Schoen Clinic Hamburg Eilbek, Hamburg, Deutschland
⁷Department of Orthopedics and Trauma Surgery, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Deutschland

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Objectives and questions: In Germany, training in spine surgery is part of two different residency programs; Neuro- and orthopedic/ trauma surgery. This study was conducted to evaluate the respondents’ subjective perception of their own training in this field regardless of specialty, and to identify possible demand for improvement.

Material and methods: The online survey of 58 questions taken by trainees and specialists after being invited via the German Spine Society newsletter and social media, inquired involvement in spine surgery, certifications, personal and departmental surgical and technical circumstances, perception of training, experience and capabilities, scientific engagement and impact on personal life. Standard statistical methods were applied.

Results: 281 Respondents took the survey; 276 properly completed surveys were included in final analysis. Most contributions originated from Germany, Switzerland and Austria. Male surgeons accounted for 65% of responses. 58% were orthopedic/ trauma surgeons. 35% of responses were from residents, 45% in their 6th year of training. Overall, 58% reported more than 50% of their practice being in spine surgery. 60% of participants had no personal spine certification. 42% worked at a spine certified facility. Most Facilities had modern surgical equipment including microsurgery, navigation and 3D imaging. Deformity surgery, lateral approaches and neuromodulation were less common among centers. 54% found their training adequate, 13% were uncertain. The average rating of spine surgery training was 3.4/5 stars. In detail 71% reported sufficient operating room (OR) time as assisting surgeon, 53% as main surgeon. 70% blamed high workload for lack of mentoring. Online lectures and videos seem to play an important role in self-education. However, mentoring in the OR remained the major education source. Scientific engagement appears of moderate relevance, only 25% of respondents were actively involved in projects. Only 29% thought spine surgery and family are compatible. 23% abandoned spine surgery due to training conditions.

Discussion and conclusions: With changing work and societal requirements in addition to increasing patient numbers and staff shortages, training in spine surgery is no doubt becoming more challenging. Training appears heterogenous among German speaking surgeons in this field, regardless of specialty. Despite technical advancements and contactless means of education, there is no substitute for personal OR mentoring.