47 © Springer Nature Switzerland AG 2019 F. M. Phillips et al. (eds.), Minimally Invasive Spine Surgery, https://doi.org/10.1007/978-3-030-19007-1_5 The Role of MI Spine Surgery in Global Health: A Development Critique Carlyn R. Rodgers and W. B. Rodgers 5 C. R. Rodgers Centre of Latin American Studies, University of Cambridge, Cambridge, UK W. B. Rodgers (*) University of Quadra, Heriot Bay, BC, Canada e-mail: brodgers@spinemidwest.com Learning Objectives/Key Points • Global Surgery 2030, The Lancet Commission’s initiative to improve access to safe surgical care, provides a transformational framework for discus- sions regarding healthcare interventions in the Global South. • The burden of disease derivative of spinal maladies in the Global South, while formerly believed to be lower, per capita, than in the Global North is, in fact, very similar, if not greater. • Minimally invasive spinal surgical techniques offer unique advantages in the treatment of spinal mala- dies in the Global South, mostly derivative of their improved complication profle when compared to traditional open surgery. • Such interventions are extremely resource-intensive and may be beyond the budgetary capacity of the Ministries of Health throughout the Global South— thus necessitating the assistance of humanitarian entities and/or industry-based nonproft foundations. • Medical and surgical interventions, whether led by humanitarian entities, government agencies, or industry-based nonproft foundations, should adhere to the best practice criteria promulgated by the World Health Organization, Global Surgery 2030, and the feld of Development. 5.1 Introduction The Lancet Commission’s Global Surgery 2030 initiative, a manifesto published in 2015 defning the importance of access to safe surgical care in the Global South as a basic human right because of surgery’s demonstrated value to patients, represents a transformational moment in the evolu- tion of the discourse on healthcare [1]. Summarized in brief, the Commission emphasized that the need for surgery is enormous and growing. Nonetheless, one must be constantly aware that, even the best of intentions do not always protect from errors of misunderstanding or unrecognized assumptions of cultural superiority. It is beyond the scope of this chapter to recount the litany of noble failures that have paved this path toward perdition or to describe in any detail the faming hulks of wasted opportunity (and squandered treasure) that light that road. It is the authors’ purpose to discuss best practices for other such interventions, specifcally as related to Global Surgery 2030. It is not our intention to criticize the honor- able intentions that motivate those who, through such col- laborations, work so diligently to improve the lives of those in need. Instead, we offer this critique as a starting point for refning future efforts to impact sustainably the treatment of patients in the Global South suffering from spinal maladies. The rapid evolution of less disruptive spinal surgery in the Global North during the last two decades has been