Impact of COVID-19 on Spinal Diagnosis and Procedural Volume in the United States

Abstract

Study Design Retrospective analysis of a national database. Objectives COVID-19 resulted in the widespread shifting of hospital resources to handle surging COVID-19 cases resulting in the postponement of surgeries, including numerous spine procedures. This study aimed to quantify the impact that COVID-19 had on the number of treated spinal conditions and diagnoses during the pandemic. Methods Using CPT and ICD-10 codes, TriNetX, a national database, was utilized to quantify spine procedures and diagnoses in patients >18 years of age. The period of March 2020-May 2021 was compared to a reference pre-pandemic period of March 2018-May 2019. Each time period was then stratified into four seasons of the year, and the mean average number of procedures per healthcare organization was compared. Results In total, 524,394 patient encounters from 53 healthcare organizations were included in the analysis. There were significant decreases in spine procedures and diagnoses during March-May 2020 compared to pre-pandemic levels. Measurable differences were noted for spine procedures during the winter of 2020-2021, including a decrease in lumbar laminectomy and anterior cervical arthrodesis. Comparing the pandemic period to the pre-pandemic period showed significant reductions in most spine procedures and treated diagnoses; however, there was an increase in open repair of thoracic fractures during this period. Conclusions COVID-19 resulted in a widespread decrease in spinal diagnosis and treated conditions. An inverse relationship was observed between new COVID-19 cases and spine procedural volume. Recent increases in procedural volume from pre-pandemic levels are promising signs that the spine surgery community has narrowed the gap in unmet care produced by the pandemic.

The Effect of COVID-19 on Spine Surgery

“…Very few studies have attempted to define the nationwide decrease in spine surgical volume due to the pandemic , with many drawing only upon institution-specific reports. 13 , 14 Furthermore, we are not aware of any previous studies that have characterized the effect of COVID-19 on outpatient spine procedures. Therefore, the purpose of this study was to analyze the impact of the COVID-19 pandemic restrictions and subsequent covid case surges on spinal surgery procedure volume as well as outpatient surgical volume.…”

Analyzing the Impact of Concomitant COVID-19 Infection on Outcomes in Trauma Patients

“…Independent of its morbidity and mortality, COVID-19 infection can complicate the presentation and management of patients presenting with a range of medical conditions. [1][2][3] In response to its association with higher thrombotic and pulmonary perioperative complications, protocols delaying elective procedures in patients with perioperative COVID-19 infection have been developed. 4,5 However, the urgency of traumatic injury requiring emergency surgery makes the implementation of such protocols impractical.…”