EUROSPINE President Ahmet Alanay is a spine surgeon treating both adult and paediatric spinal disorders. He established the Comprehensive Spine Center at Acibadem Maslak Hospital in 2013. Since then, he is the medical director of the center and is also a faculty member at Acibadem University School of Medicine. Each year, with his team, he treats over 2500 outpatients.
SSN: What drove you to choose surgery as a career, and spinal surgery in particular?
AA: My fascination with the complexities of the human spine and the fact that it is an area where many things are gray or unknown—making it incredibly attractive for my research-oriented mind—drove me towards spinal surgery. The profound impact that spinal disorders can have on a person’s quality of life further motivated me. I wanted to be part of a field where I could make a tangible difference, not just in patient care but also through research and innovation. Helping patients regain mobility, reduce pain, and ultimately improve their quality of life has been incredibly fulfilling. The challenge of treating both adult and paediatric spinal disorders has made this journey particularly rewarding.
SSN: It is clear that the healthcare industry is still being impacted since the pandemic. What has been the greatest impact for you within the spinal care and industry?
AA: The COVID-19 pandemic has significantly impacted spinal care in several ways. One of the greatest changes has been the shift toward telemedicine and remote patient management. While this has allowed us to maintain continuity of care, especially during lockdowns, it also presented challenges in assessing complex degenerative spinal conditions without in-person evaluations. Additionally, the pandemic has accelerated the need for less invasive procedures, as patients have been more hesitant to undergo surgeries that require extended hospital stays. We’ve had to adapt quickly, incorporating new technologies and approaches to ensure that our patients continue to receive the highest standard of care despite these challenges. This period has also highlighted the importance of multi-interdisciplinary collaboration and flexibility in our treatment strategies, which I believe will continue to shape the future of spinal care.
SSN: As current president of EUROSPINE, what have been your highlights and achievements working alongside the Spine Society of Europe?
AA: Three years ago, when I joined the presidential line as president-elect, we were in the post-COVID period. It was a challenging time marked by financial setbacks, weakened connections with our members, and the continuation of many post-COVID issues. Of course, the most important asset for any society is the interest, participation, and loyalty of its members. However, over the past three years, with smart strategies, we have become one of the fastest-recovering scientific societies.
One of my key focuses has been deepening member loyalty and engagement. To achieve this, we’ve made significant strides in diversity and inclusivity through initiatives like nurturing the next generation of EUROSPINE professionals and honouring our heritage. We established task forces within the community and leadership council, leading to important progress in these areas. The spine professional development pathway we are working on will make a significant contribution to training the future leaders in spine care.
We have taken significant steps to further develop our relationships with international spine societies, and one of these steps is the collaboration agreement we signed with The Japanese Society of Spine Surgery and Related Research (JSSR). An important aspect of this agreement is the fellow exchange program, which I believe is particularly valuable for our young members. In 2025, we will be sending two young members to Japan for a two-week fellowship.
One of EUROSPINE’s most valuable assets is our Annual Meeting. Since its inception 25 years ago, the Annual Meetings have always been one of the most prestigious and well-attended spine conferences in the world. Despite the post-COVID era, the radical and bold changes we implemented in the meeting format over the past three years have paid off. Especially in the last two years, we have seen participant numbers return to pre-COVID levels. Each year, the scientific quality improves, and this year, I am expecting over 3,500 participants. From the number of abstracts submitted and early registrations, I can already tell this year will be exceptional. With an outstanding agenda, excellent scientific content, and a world-class faculty, I invite the entire spine community to join us in one of the most beautiful cities in the world, Vienna.
There is so much more to share, but to summarize, we have made significant advancements in quality assurance in spine care through our interdisciplinary care courses (EDISC), spine registry and benchmarking practices (Spine Tango), and the Certificate for Spine Centers of Excellence program. Despite the reduced support during the pandemic, our research council has reestablished important grants for spine researchers and forged key connections for new funding sources.
One of the encouraging developments during my presidency was that our joint publication with EANS, the Brain & Spine Journal, achieved an impact factor of 1.9 in just three years. Our journal is rapidly becoming one of the prestigious spine journals, and we invite all researchers to consider submitting their work to our journal.
In conclusion, during my tenure in the presidential line, I believe that ensuring the sustainability and growth of EUROSPINE in a rapidly evolving healthcare landscape has been a significant achievement.
SSN: Are you currently involved in research looking into new technology and techniques, and if so, could you tell us more about your aims and outcomes?
AA: Yes, despite being an extremely busy surgeon, I remain highly active in research, which is a passion of mine. This is largely thanks to the strong research team I have and my involvement with the European Spine Study Group (ESSG) and the Harms Study Group. Every year, my work, published in over 15 Q1 and Q2 journals, covers various topics, but there are two areas where I have made significant contributions to spinal surgery.
One of these is the GAP concept and GAP score, which we developed for preoperative planning and mechanical complication risk prediction in adult spinal deformity. Since its first publication in JBJS in 2017, it has become one of the most cited clinical medical research articles. It is incredibly gratifying to see it widely used today for planning around the world. Currently, we are finalizing a planning software based on the GAP concept.
In addition to this, another area where I have been a pioneer, and which is the focus of my recent work, is improving the outcomes of Vertebral Body Tethering (VBT) surgery and developing new hybrid solutions. We are analysing long-term data to refine techniques and expand indications. The goal is to provide safer and more effective treatments for patients with scoliosis, particularly those who would benefit from a non-fusion approach.
SSN: What could this research mean for patient outcomes and the future of spinal surgery?
AA: The GAP concept has become an essential tool in preoperative planning for adult spinal deformity, particularly in helping to prevent mechanical complications, which are the most significant issue in these surgeries. If you look at the spine industry today, there is a substantial investment in AI-based software for preoperative planning and the prevention of mechanical complications, which are costly to healthcare systems. The use of pre-bent rods, based on these calculations, is also on the rise. The GAP concept is one of the key alignment goals that supports these planning processes. Ultimately, I believe that 70% of alignment is based on mathematical calculations, while 30% involves other biological factors. Although preoperative planning is more commonly used by academic surgeons, it is not yet widespread in the field. As a result, we, as academic centres, perform many revision surgeries due to mechanical complications.
Planning and calculations can be somewhat complex for pragmatic surgeons, but I believe that using image recognition-based calculators that allow surgeons to perform their own planning is more valuable than relying on closed systems that produce pre-bent rods based on engineers’ decisions. Our work is progressing in this direction.
Our second research focus, VBT, could lead to more personalized and less invasive treatment options for scoliosis patients, reducing the need for traditional fusion surgeries. This would not only improve long-term outcomes but also enhance the overall quality of life for patients, especially younger ones. In a broader context, it could help establish new standards in scoliosis surgery that prioritize motion preservation and faster recovery.
SSN: What’s the best part of your job?
AA: The best part of my job is seeing the positive impact my work has on patients’ lives. Whether it’s a child standing tall after scoliosis surgery or an adult resuming an active life, those moments of transformation are incredibly rewarding.
SSN: … and the worst?
AA: The most challenging aspect is dealing with cases where, despite our best efforts, the outcomes are not as we had hoped. Surgery always carries risks, and managing those difficult moments with patients and their families is never easy.
SSN: What has been the highlight of your career so far?
AA: One of the highlights of my career has been pioneering Vertebral Body Tethering surgery in Europe. It’s been gratifying to see how this technique has evolved and how it’s offered new hope to patients who were previously limited to traditional fusion surgery.
SSN: As well as EUROSPINE, will you be attending or speaking at any other medical conferences or events over the next year?
AA: Yes, in addition to EUROSPINE, I will be attending and speaking at various conferences including the Scoliosis Research Society (SRS) Annual Meeting in Barcelona and other key international events focused on spinal disorders. These platforms allow me to share our latest research findings and collaborate with colleagues from around the world.
SSN: If you weren’t a spinal surgeon, what would you be?
AA: If I weren’t a spinal surgeon, I would probably have pursued a career in academic research, as I have always been passionate about advancing medical knowledge and improving patient care through scientific inquiry.
SSN: What would you tell your 21-year-old self?
AA: I would tell my 21-year-old self to remain curious and committed to lifelong learning. The field of medicine is constantly evolving, and the ability to adapt and innovate is crucial. Also, never underestimate the importance of mentorship and collaboration. Finally, be a spine surgeon!
SSN: If you were Health Minister for the day, what changes would you implement?
AA: If I were Health Minister for a day, I would prioritize improving access to specialized care, particularly for patients with chronic conditions like spinal disorders. Additionally, I would invest heavily in preventive care and public health initiatives aimed at reducing the burden of adult spinal deformity and degenerative diseases. One of our ESSG studies, published in the European Spine Journal, clearly demonstrated that the adult spinal deformity “pandemic” is growing and impacting health-related quality of life as significantly as other chronic diseases such as diabetes, COPD, and hypertension. Addressing this issue would be a key focus of my efforts to improve overall healthcare outcomes.
Adult spinal deformities are conditions where non-operative management is often unsuccessful, and surgical treatment carries significant risks and costs. Additionally, since the degenerative process is a continuum, patients often require repeated, more expensive surgeries over time. While we have made important advances in this field over the last 20 years, it is clear that prevention or delaying the progression of these conditions would be a more cost-effective and less risky solution. Therefore, my focus would be on implementing strategies that prevent or delay the onset of these conditions to improve patient outcomes and reduce healthcare costs.
SSN: Away from the clinic and operating theatre – what do you do to relax?
AA: Most of my time outside the clinic and operating theatre is spent on research, scientific talks, zoom meetings or traveling for my duties with various medical societies. In the remaining time, I enjoy spending time with my family, staying active through sports, and either watching or attending football matches as a passionate supporter.
SSN: How do you think the future looks in the field of spinal surgery, and what are your predictions for 2025 and the next decade?
AA: The future of spinal surgery is likely to see a continued shift toward minimally invasive and personalized approaches. By 2025 and beyond, I anticipate significant advancements in technology, such as robotics and AI, which will enhance precision and outcomes. Additionally, motion-preserving techniques will likely become more common, reducing the need for traditional fusion surgeries and improving patient quality of life. Last but not least, the EUROSPINE Annual Meeting is expected to reach 5,000 participants.
For more details about this year’s EUROSPINE event, visit: EUROSPINE
