OBJECTIVES: This study was performed to compare hospitalizations for spinal surgery development across France, Spain and Germany from 2010 to 2013 and to analyze patient’s characteristics. METHODS: A retrospective analysis was conducted from hospital databases PMSI for France, CMBD for Spain and SHI for Germany between 2010 and 2013. All spinal surgery hospitalizations were collected based on procedure codes according to the respective classification of each country (CCAM for France, ICD-9 for Spain and OPS for Germany). The mapping of ICD-9 and OPS codes was undertaken from the French procedures. Standardization of rates of spinal surgery patients were based on age from the EU population RESULTS: In 2013, crude rates of hospitalized patients with spinal surgery were 6.43 per 10,000 in Spain, 18.95 per 10,000 in France and 66.27 per 10,000 in Germany. All 3 countries experienced an increase of this number of patients from 2010 to 2013: +14% in Spain, +17% in France and +18% in Germany. The gender distribution was similar between all countries, with slightly more women treated in Spain and Germany: 52% versus 50% in France. Mean age was lower in Spain (53 ± 16 years) and France (54 ± 17 years) than in Germany (59 ± 15 years); the [70-80] year group was overrepresented in Germany (24% of patients versus 15% in France and Spain) to the detriment of the [30-40] year group (6% of patients in Germany versus 15% in France and Spain). The age standardized rates of spinal surgery patients were higher in Germany (60.55 per 10,000) than in France (19.91 per 10,000) and Spain (6.53 per 10,000). CONCLUSIONS: Between 2010 and 2013, spinal surgery was marked by a progression of more than 14% in each country. The standardized rate of spinal surgery patients varied significantly between the 3 countries, Germany having the highest one.