The impact of the COVID-19 pandemic on spinal surgery

Wordie, Sarah J

doi:10.1016/j.mporth.2021.09.001

Cited by 13 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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.…”

Section: Introductionmentioning

confidence: 99%

The Effect of COVID-19 on Spine Surgery

Mills

Mertz

Faye

et al. 2023

Global Spine Journal

View full text Add to dashboard Cite

Study Design/Setting Retrospective cohort analysis Objectives To characterize the impact of COVID-19 on utilization of the ten most common spine procedures and percentages of outpatient procedures. Methods The PearlDiver national database was queried from January 2010 to April 2021 for short (<6 segments) and long segment posterior instrumented fusion (≥6 segments), posterior cervical fusion, anterior cervical decompression and fusion (ACDF), cervical laminectomy, laminoplasty, and disc arthroplasty, lumbar laminectomy, microdiscectomy, and interbody fusion. Annual procedure utilization between January 2010 through April 2021 was recorded and compared. Monthly trends were compared to January 2020. Outpatient trends were compared between 2010-2019 and 2019-2021 using segmented linear regression. Results Overall, all ten procedures decreased 4.3% in 2020 compared to 2019 and increased 6.3% in 2021 compared to 2019. March and April of 2020 had the largest decreases, with March 2020 decreasing 18.2% and April 2020 decreasing 51.6% compared to January 2020. Despite increasing COVID cases in January 2021, overall procedure utilization decreased only 1.8% compared to January 2020, and increased later in 2021 with April 2021 case volumes increasing by 138% compared to January 2020. Outpatient utilization of short segment posterior lumbar fusion and lumbar interbody fusion significantly increased during this time ( P < .001). Conclusion The greatest impact on spine surgery volume from the COVID-19 pandemic occurred in March and April 2020. Spine procedure utilization was otherwise similar or increased compared to January 2020. Additionally, the volume of outpatient short segment posterior fusion and lumbar interbody fusions increased during this time period.

show abstract

Section: Introductionmentioning

confidence: 99%

The Effect of COVID-19 on Spine Surgery

Mills

Mertz

Faye

et al. 2023

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…Evidence from the early phases of the ongoing COVID-19 pandemic suggests that routine and emergency spine procedures were significantly impacted by provisions and shifts in allocation of in-hospital resources toward COVID-19 care. 1 2 3 4 5 6 7 A comprehensive assessment of the true influence the pandemic has been having on surgical spine care is limited mainly by a lack in long-term observations from later phases of the pandemic on a nationwide level. We therefore designed this study to examine potential changes in the delivery of spinal fusion procedures for spinal infections (SI), such as spondylodiscitis and vertebral osteomyelitis, during the first four waves of COVID-19 in Germany.…”

Section: Introductionmentioning

confidence: 99%

Effects of the COVID-19 Pandemic on Spinal Fusion Procedures for Spinal Infections in a Nationwide Hospital Network in Germany

Abduljawwad

Pamnani

Stoffel

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

Background The full impact of the COVID-19 pandemic on surgical spine care is difficult to assess due to a lack in nationwide evidence from more recent phases of the pandemic. We aimed to describe changes in in-hospital processes associated with spinal fusion procedures in the treatment of spinal infections (SI) during different phases of the pandemic. Methods In this retrospective observational study, we examined the in-hospital prevalence and outcomes of spinal fusion procedures for SI (along with patient characteristics, rates of transfer to intensive care units, and mortality rates) during the first four waves of the pandemic compared with the corresponding prepandemic periods in 2019. We used administrative data from a nationwide network of 76 hospitals managing 7% of all in-hospital cases in Germany. Results We observed no significant change in the prevalence of SI fusion procedures during the pandemic, neither in total numbers (349 vs. 373) nor for each wave separately. On a patient level, we found no differences in age, sex, and the prevalence of paresis, and no relevant differences in associated comorbidities. The rate of mechanical ventilation did not change during any of the examined pandemic waves: it ranged between 9.5 and 18.6% during the pandemic and 3.1 and 16.0% during the corresponding prepandemic control periods. The rate of transfer to intensive care changed only during wave 4 (from 70.4 to 54.8%; p = 0.046) but not in any other pandemic phases. We observed no changes in in-hospital mortality rates (range: 2.9–9.7% vs. 6.2–11.3%) or in duration of hospital stay (range: 26.2–30.8 days vs. 20.8–29.2 days). Conclusions The main finding of our study is that within this nationwide network of spine care centers in Germany, the delivery of surgical treatment of SI by means of spinal fusion procedures was maintained throughout the first four waves of the pandemic. Furthermore, there were no relevant changes in patient demographics, in-hospital processes, and mortality rates.

show abstract

“…Deferring non-urgent cases, due to administrative restrictions in the form of surgical rationing or patient hesitancy may influence the overall health risk of patients the longer a procedure is postponed [ 5 , 6 , 7 , 8 ]. Specifically, reductions in quality of life during the postponement period, as well as the impact of postponement on disease progression, possibly lead to the need for a more complex and expensive surgery with longer recovery time and poorer outcomes [ 5 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study of the Impact of COVID-19 Pandemic Related Administrative Restrictions on Spine Surgery Practice and Outcomes in an Urban Healthcare System

Attaripour

Xiang

Mitchell

et al. 2022

IJERPH

View full text Add to dashboard Cite

The study objective is to characterize the impact of COVID-19 related hospital administrative restrictions on patient demographics, surgical care, logistics, and patient outcomes in spine surgery. This was a retrospective study of 331 spine surgery patients at UCSD conducted during 1 March 2019–31 May 2019 (pre-COVID-19) and 1 March 2020–31 May 2020 (first COVID-19 surge). All variables were collected through RedCap and compared between pre- and during-COVID groups. There were no significant differences in patient demographics, operating room duration, and skin-to-skin time. However, length of stay was 4.7 days shorter during COVID-19 (p = 0.03) and more cases were classified as ‘urgent’ (p = 0.04). Preoperative pain scores did not differ between groups (p = 0.51). However, pain levels at discharge were significantly higher during COVID (p = 0.04) and trended towards remaining higher in the short- (p = 0.05) but not long-term (p = 0.17) after surgery. There was no significant difference in the number of post-operative complications, but there was an increase in the use of the emergency room and telemedicine to address complications when they arose. Overall, the pandemic resulted in a greater proportion of ‘urgent’ spine surgery cases and shorter length of hospital stay. Pain levels upon discharge and at short-term timepoints were higher following surgery but did not persist in the long term.

show abstract

The impact of the COVID-19 pandemic on spinal surgery

Cited by 13 publications

References 21 publications

The Effect of COVID-19 on Spine Surgery

The Effect of COVID-19 on Spine Surgery

Effects of the COVID-19 Pandemic on Spinal Fusion Procedures for Spinal Infections in a Nationwide Hospital Network in Germany

A Retrospective Study of the Impact of COVID-19 Pandemic Related Administrative Restrictions on Spine Surgery Practice and Outcomes in an Urban Healthcare System

Contact Info

Product

Resources

About