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. 2020 Nov;16(Suppl 1):77-84.
doi: 10.1007/s11420-020-09797-x. Epub 2020 Sep 15.

Early Peri-operative Outcomes Were Unchanged in Patients Undergoing Spine Surgery During the COVID-19 Pandemic in New York City

Philip K Louie  1 , Lauren A Barber  1 , Kyle W Morse  1 , Marie Syku  1 , Sheeraz A Qureshi  1 , Virginie Lafage  1 , Russel C Huang  1 , Alberto V Carli  1
Affiliations

Early Peri-operative Outcomes Were Unchanged in Patients Undergoing Spine Surgery During the COVID-19 Pandemic in New York City

Philip K Louie et al. HSS J. 2020 Nov.

Abstract

Background: Healthcare resources have been greatly limited by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic halting non-essential surgical cases without clear service expansion protocols.

Questions/purposes: We sought to compare the peri-operative outcomes of patients undergoing spine surgery during the SARS-CoV-2 pandemic to a matched cohort prior to the pandemic.

Methods: We identified a consecutive sample of 127 adult patients undergoing spine surgery between March 9, 2020, and April 10, 2020, corresponding with the state of emergency declared in New York and the latest possible time for 1-month surgical follow-up. The study group was matched one-to-one based on age, gender, and body mass index with eligible control patients who underwent similar spine procedures prior to the SARS-CoV-2 outbreak. Surgeries performed for infectious or oncologic indications were excluded. Intra- and post-operative complication rates, re-operations, hospital length of stay, re-admissions, post-operative visit format, development of post-operative fever and/or respiratory symptoms, and SAR-CoV2 testing.

Results: A total of 254 patients (127 SARS-CoV-2 pandemic, 127 matched controls) were included. One hundred fifty-eight were male (62%), and 96 were female (38%). The mean age in the pandemic group was 59.8 ± 13.4 years; that of the matched controls was 60.3 ± 12.3. All patients underwent general anesthesia and did not require re-intubation. There were no significant differences in 1-month post-operative complication rates (16.5% pandemic vs. 12.6% control). There was one death in the pandemic group. No patients tested positive for the virus.

Conclusion: This study represents the first report of post-operative outcomes in a large group of spine surgical patients in an area heavily affected by the SARS-CoV-2 pandemic.

Keywords: COVID-19; SARS-CoV-2; coronavirus; elective surgery; orthopedics; spine surgery; telemedicine.

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Conflict of interest statement

Conflict of InterestPhilip K. Louie, MD; Lauren A. Barber, MD; Kyle W. Morse, MD; Marie Syku, BS; Virginie Lafage, PhD; Russel C. Huang, MD; and Alberto V. Carli, MD, declare that they have no conflicts of interest. Sheeraz A. Qureshi, MD, MBA, reports personal fees from Stryker K2M, Globus Medical, Inc., Paradigm Spine, RTI Surgical Inc., AMOpportunities, Healthgrades, and Simplify Medical, Inc.; investment or ownership interest in Avaz Surgical and Vital 5; committee or board membership in the International Society for the Advancement of Spine Surgery, Global Spine Journal, The American Orthopaedic Association, North American Spine Society, LifeLink.com Inc., Association of Bone and Joint Surgeons, Society of Lateral Access, Spine (Journal), The Spine Journal, Society of Minimally Invasive Spine Surgery, Minimally Invasive Spine Study Group, Spinal Simplicity, LLC, Contemporary Spine Surgery, Annals of Translational Medicine, Journal of American Academy of Orthopaedic Surgeons, and Cervical Spine Research Society, outside the submitted work.

Figures

Fig. 1
Fig. 1
Heatmap representing primary residence of surgical patients. This heatmap depicts the location of the surgical patients’ primary residence. The numbers listed describe the number of patients who reside in that respective state. The greatest density of patients presented from downstate New York.
Fig. 2
Fig. 2
Surgical volume and pertinent milestones during the pandemic. The graph represents cumulative surgical volume over the study period. Specific milestones are described and marked by a vertical line. On March 16, 2020, PPE became widely available for all hospital staff. The next day on March 17, the hospital suspended all elective surgeries. On March 23, COVID-19 testing became available for all inpatients and operative patients. Lastly on March 29, our hospital began accepting COVID-19-positive patients from a nearby hospital.
See this image and copyright information in PMC

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