Joseph E Nassar, Nathaniel W Jenkins, Shamar Bailey, Deandra Poyser, Marcus John, Micheal Raad, Shay Bess, Peyton Lawrence, Ian Neil, Stephen George, Charla Fischer, Jaysson T Brooks, Emmanuel N Menga
Spine surgery missions in low-resource settings can meaningfully close global gaps in access to care but require careful logistical and relational planning. Drawing on collaborative missions within 2 Jamaican hospital systems under the Back to Healing nonprofit initiative, we review financial realities, logistical barriers, ethical responsibilities, and human dimensions that define high-impact missions. Success depends on financial planning and transparency, equipment logistics, intraoperative adaptability, and operating room throughput, but equally on sustained partnership with host institutions and local teams. Patient selection carries particular ethical weight under resource constraints, and training and research opportunities further support long-term collaboration. Practical recommendations are offered for surgeons and institutions planning missions.