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Khattab and Bourghli: Commentary on “History of Spinal Neurosurgery and Spine Societies”
To the editor
We have read with great interest the article by Zileli et al. [1], which reported the History of Spinal Neurosurgery and Spine Societies. We appreciate the author’s effort to highlight the history of spine societies worldwide. However, we have great concerns regarding the section that was written about Egypt as it contains several inaccurate and misleading statements.
It is true that Egypt is a major contributing country in Africa and the Middle East in regards to spine surgery history and early interventions. Nevertheless, spine practice in Egypt is not mostly done by neurosurgeons as stated in the study. In fact, it has been performed equally by neurosurgeons and orthopedic surgeons side by side during the past decades, similarly to the majority of the countries in the current era [2], and the role of orthopedic surgeons in spine performance cannot be overlooked and reduced to deformity correction surgeries as they also perform degenerative, traumatic and tumor pathologies including in the cervical spine which is an area that has been traditionally linked to neurosurgery in many countries in the past. A recent paper on the impact of coronavirus disease 2019 (COVID-19) pandemic on spine surgeons worldwide used a specific questionnaire including demographic information that was submitted to the surgeons, and showed that the majority of participants were spine surgeons from Egypt with detailed data revealing a higher number of orthopedic surgeons compared to neurosurgeons [3].
Apart from the spine chapter in the Egyptian orthopedic Association and the spine chapter in the Egyptian society of neurological surgeons, Egypt has two big spine societies and a simple search on Google engine with the following keywords “Egypt,” “Spine,” “Scoliosis,” “Society” would reveal them. The Egyptian spine Association (ESA), as it was mentioned in the study, that was founded in 2011 by orthopedic and neurosurgery leaders in Egypt, it has been having regular scientific activities [4] and annual meetings in collaboration with international societies since 2012 until the last one in 2020 in the hybrid form given the COVID-19 pandemic, with no interruption in its activities contrary to what was mentioned in the study, in fact the meetings calendar on the ESA website clearly demonstrate the aforementioned statement (http://esa.org.eg/meetings_calendar.asp). The official journal of ESA is the Egyptian Spine Journal. The second society is the Egyptian Scoliosis Society which was established in 2002, almost 20 years ago, by Prof. Youssry El Hawary, past head of the orthopedic department in Cairo University, it includes over 230 members and holds regular annual meetings under the name “Scoliosis Week” which includes a scientific program specifically dedicated to spine deformities ending with live surgery demonstrations performed by renowned surgeons (https://www.facebook.com/Egyspine/).
Lastly, and besides the previously mentioned societies, the Egyptian Spine Study Group was founded in 2017 by Dr Mohamed Khattab. It is a spine dedicated group that has the aim to foster spinal education and research from junior to senior level of practice. With over 250 members, it organizes regular journal clubs and webinars providing up-to-date spinal knowledge and guidelines (https://egyssg.hpgportal.com).
We again commend the author’s effort in presenting this interesting study but in our view, some information were inaccurate and misleading giving a wrong and unfair picture about the structure, organization and development of spine surgery in a country like Egypt.


The authors have nothing to disclose.


1. Zileli M, Sharif S, Fornari M, et al. History of Spinal Neurosurgery and Spine Societies. Neurospine 2020 17:675-94.
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2. Pejrona M, Ristori G, Villafane JH, et al. Does specialty matter? A survey on 176 Italian neurosurgeons and orthopedic spine surgeons confirms similar competency for common spinal conditions and supports multidisciplinary teams in comprehensive and complex spinal care. Spine J 2018 18:1498-503.
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3. Khattab MF, Kannan TMA, Morsi A, et al. The short-term impact of COVID-19 pandemic on spine surgeons: a cross-sectional global study. Eur Spine J 2020 29:1806-12.
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4. Khattab MF, Abou-Madawi AM. Current effect of COVID-19 global pandemic on the professional and life profiles of the Egyptian spine surgeons. SICOT J 2020 6:31.
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