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The AO Foundation (Arbeitsgemeinschaft für Osteosynthesefragen—Association for the Study of Internal Fixation—commonly called AO) was established in 1958 by a group of Swiss surgeons to address diseases and inju­ries to the musculoskeletal system and has now grown to become a highly inuential worldwide organisation. Distribution and sales of all AO products are done through Synthes via a subsidiary! From March 2006, Synthes acquired existing Synthes-branded products from the AO Foundation. Within the AO Foundation, a group of spine surgeons led by John Webb, Max Aebi and Paul Pavlov sup­ported by the AO’s industrial partners pushed for greater autonomy for the spine surgeons within the AO.As a conse­quence of this development, the AO Spine International was established in June 2003. Today, the AO Spine has a mem­bership of around 4500 surgeons, researchers and allied spine professionals. The American Board of Spine Surgery (ABSS) and the American board of spinesurgery.org were established in 1997 and 1999, respectively. The ABSS sets standards for professional training and certication in spine surgery, promoting quality assurance, while the American College of Spine Surgery encourages sponsors and accredits suitable training programmes. Its primary goal is to assist the public and the medical profession by setting educational and postgraduate training requirements for spine surgeons and by promoting continuing quality assurance programmes. As the list in Table1.1 demonstrates, a great many organisa­tions have come into being, sometimes in competition with one another. They include purely scientic non-prot organ­isations and scientic societies allowing links with industry and bodies representing particular professional interests (boards and academies). For some of these organisations,