Recommendatory base for the delivery of specialized medical care to patients with spine and spinal cord injury in Russia: Subject field review

Objective. To evaluate the composition and content of the recommendatory base for delivery of specialized medical care to patients with spine and spinal cord injury on the territory of the Russian Federation. Material and Methods. The published recommendations specifying the content of the diagnostic, therapeutic, rehabilitation and preventive components of the provision of medical care to patients with spine and spinal cord injury were reviewed. The search for information was carried out in the eLibrary.ru bibliographic resource, documents of the Ministry of Health of the Russian Federation, publications of specialized medical professional non-profit organizations, and other manuals. The depth of information selection was 18 years (since 2003). The review was prepared following the PRISMA-ScR and PRISMA-S guidelines. Results. The current Russian recommendatory base in the field under consideration includes articles in peer-reviewed scientific journals, practical guidelines, regulatory documents and eight clinical guidelines prepared by the Association of Traumatologists and Orthopedists of Russia and by the Association of Neurosurgeons of Russia approved or submitted for approval by the Ministry of Health. A significant degree of cross-use of information has been established, in general covering a wide range of diagnostic, therapeutic, rehabilitation and preventive issues. Conclusion. Most of the Russian recommendations on the provision of medical care to patients with spine and spinal cord injury do not have high strength, are not based on high-certainty evidence, are general in nature, especially in terms of diagnostic and therapeutic tactics, and are created without consideration of the medical care delivery setting. The methodology for their development is reported extremely poorly.