The State of Spine Surgery in the Kingdom of Saudi Arabia.

Spine surgery in the Kingdom of Saudi Arabia (KSA) has undergone remarkable transformation over the past three decades. It has evolved from a service concentrated in a handful of tertiary referral hospitals into a maturing, multidisciplinary specialty distributed across governmental, academic, and private institutions. We describe the current state of spine surgery in the context of its geography, demography, and rapidly reforming health system. The country's vast territory and its young, urbanizing population of more than 35 million generate a distinctive burden of spine disease, including congenital deformities, trauma related to road traffic accidents, and a rising tide of degenerative spinal disorders driven by lifestyle changes, obesity, and increasing life expectancy. The main spine surgery centers, the spectrum of procedures typically performed, and the penetration of novel techniques are reviewed together with the enabling technologies now being introduced under the Vision 2030 Health Sector Transformation Program. In this editorial, we present the current state of spine surgery in KSA and shed light on priority areas for advancement, including a national spine registry, structured endoscopic and robotic training pathways, equitable regional access, and higher-quality international collaborative conferences and research.