Minimally Invasive Procedures, Perioperative Telemedicine, and Decreased Hospital Stays Following Covid-19 Surgical Restrictions: Spinal Surgery

Abstract

The 2019 severe acute respiratory syndrome coronavirus 2 pandemic had devastating impacts on healthcare system operations. Disruption of this delicate system led to international healthcare challenges with new policy changes that affected all specialties, including the global spine surgery community. The pandemic disrupted normal spine surgery proceedings, restricting, and postponing elective procedures, which comprise a large proportion of spine surgeries. This disruption may have contributed to significant economic losses for providers and resulted in the prolonged impairment of patients who were forced to postpone their procedures. However, response to the pandemic precipitated new procedural guidelines and practices that prioritize health outcomes and satisfaction. These new changes and innovations are positioned to provide lasting economic and procedural impacts in favor of both providers and patients. Thus, the objective of our review is to explore how spinal surgical practices and post-op recovery changed following COVID-19 and highlight some lasting impacts the pandemic created for future patients.

The COVID-19 Pandemic and Elective Spine Surgery—A Single Center Experience

“…We observed a decrease of 22.1% in the number of procedures in the initial year of the pandemic compared to the year before (263 surgeries in 2019 and 205 surgeries in 2020). This finding is in line with other contemporary studies that reported a decrease in other elective surgeries in these unique circumstances [ 19 , 20 , 22 , 23 , 24 , 25 , 26 ]. The described reduction in surgical volume is most likely a direct consequence of reorganization of healthcare in order to better treat patients with COVID-19, but at the same time to limit the spread of SARS-CoV-2 in hospitals.…”

“…The described reduction in surgical volume is most likely a direct consequence of reorganization of healthcare in order to better treat patients with COVID-19, but at the same time to limit the spread of SARS-CoV-2 in hospitals. Simultaneously, surgical specialties adapted and increased the utilization of telemedicine in treatments of their patients [ 21 , 25 ], with the same goal of limiting exposure to the virus. In contrast, in our study, the number of elective procedures during the second year of the pandemic increased by 36.1% when compared to the initial pandemic year (205 surgeries in 2020 and 279 surgeries in 2021).…”

“…However, the data of elective spine surgeries in this specific period are still growing. Several authors have described their observations of neurosurgical practice adaptations—these studies reported declines in elective spinal procedures [ 22 , 23 , 24 , 25 , 26 ]. In this study, we seek to investigate the trends in volume of elective lumbosacral spine surgery prior to the pandemic and during the pandemic.…”