•Most spinal trauma occurs in low- and middle-income countries (LMICs), but some elements may limit the application of current guidelines.•In LMICs, a respectable proportion of physicians treating spinal trauma is not aware of any guidelines on this topic.•Most physicians managing spinal trauma in LMICs believe that following the guidelines may positively affect patient outcomes.•Most believed they have the capability to apply, the guidelines, but variation according to income and geographical region exists.•The perceived limitations and their relevance to guideline adherence vary across different income and geographic areas worldwide.•Resource-targeted guidelines for spinal trauma are considered a valuable option to overcome the limitations of real-life application of the current guidelines.