Advice on Standardized Diagnosis and Treatment for Spinal Diseases during the Coronavirus Disease 2019 Pandemic

Abstract

Coronavirus disease 2019 outbreak started in December 2019 that caused difficulties for clinical work. Practical work experience in our spinal outpatient and emergency department during the COVID-19 pandemic is summarized in this article, with combined evidence-based medical evidence to explore a standardized process of diagnosis and treatment for spinal diseases. Outpatient reservation, continuous screening, triage, and isolation, first consultation accountability system, pandemic reporting system, and online revisit were strictly followed. We hope that our experience in prevention and control of COVID-19 can help spine surgeons globally in stopping the spread of COVID-19. Spine surgeons should collaborate with infection control specialists to avoid cross-infection in hospitals and optimize treatment.

Management of Traumatic Spinal Fracture in the Coronavirus Disease 2019 Situation

“…The authors designed an algorithm to assess patients, presented in Fig.1. This is in contrast to the previous review, "Advice on standardized diagnosis and treatment for spinal diseases during the coronavirus disease 2019 pandemic, " which suggested that chest computed tomography and SARS-CoV-2 nucleic acid test should be performed three days before surgery [3,6]. Patients with confirmed COVID-19 should be transferred to the isolation ward for further treatment.…”

“…During the COVID-19 pandemic, it has been determined that all patients undergoing elective spine surgery should first receive COVID-19 screening to prevent nosocomial cross-infection. However, patients in emergency departments are more critical and serious, presenting with conditions including open fractures, multiple long bone fractures, and spinal fracture that require intermediate or emergency surgical intervention [3]. In this article, the authors describe their clinical practice guidelines for the management of COVID-19 in trauma patients with spine fractures.…”

Spine Surgical Procedures during Coronavirus Disease 2019 Pandemic: Is It Still Possible to Take Care of Patients? Results of an Observational Study in the First Month of Confinement

“…In such cases, many adaptations in the health care structures are necessary with specific isolated rooms and operative theaters for COVID+ patients and the need for perfect coordination between all healthcare professionals [6,7]. According to Zou et al [5], the first step of management is related to screening for COVID-19 symptoms and triage of the patients that would require a surgical procedure. In our experience, we used systematic preoperative PCR-testing and reserved chest-CT-scan for suspected cases.…”

“…In the entire series comprising 62 patients, only one tested COVID+ preoperatively and underwent surgery with the previously described protections measures [5].…”

Letter to the editor by Dobran Mauro, Paracino Riccardo, and Iacoangeli Maurizio regarding “Neurosurgery during the COVID-19 pandemic: update from Lombardy, northern Italy.” Zoia C, Bongetta D, Veiceschi P, Cenzato M, Di Meco F, Locatelli D, Boeris D, Fontanella MM. Acta Neurochir (Wien). 2020 Mar 28. doi: 10.1007/s00701-020-04305-w

“…Dear Editor, we read with great interest the article by Cesare Zoia, Daniele Bongetta, Pierlorenzo Veiceschi, Marco Cenzato, Francesco Di Meco, Davide Locatelli, Davide Boeris, and Marco M. Fontanella "Neurosurgery during the COVID-19 pandemic: update from Lombardy, northern Italy" [4]. This study provided important insights into the management of patients with the COVID-19 disease discovered in Wuhan [5] and the interpretation of these findings may be enhanced by the following considerations. In Italy since February 2020 spread a massive coronavirus disease (COVID-19) with a great number of infected patients and deaths.…”