Has Public Interest in Elective Spine Surgery Returned to Pre-COVID 19 Levels? A Google Trends Analysis

Objective To utilize Google trends to examine the effects of changing rules and regulations on public interest regarding elective spine surgery.  Methods This is a retrospective review analyzing data from Google trends to quantify public interest in elective cervical and lumbar fusion as restrictions related to COVID-19 were released. Three time periods were created surrounding the release of restriction on elective surgery on March 13, 2020, by the Centers for Medicare and Medicaid Services (CMS). "Pre-COVID" was defined as the four-month period directly preceding the national ban on elective surgery (11/13/2019 to 3/13/2020). "COVID" was defined as the four-month time period directly after the national ban on elective surgery (3/13/20-7/13/20), and "Post-COVID" was defined as the time period starting four months after the restrictions on elective surgeries first took place (7/13/20-11/13/20). Relative search volume (RSV) was assessed during all three time periods and compared using an analysis of variance test.  Results Search volume for all terms pertaining to cervical and lumbar fusion declined precipitously after the release of restrictions on elective surgery. Additionally, search volume has yet to return to pre-pandemic levels. However, for many of the terms public interest has been steadily increasing and signals the return in demand for these procedures.  Conclusion Public interest in elective spine surgery has been increasing as restrictions continue to loosen and many patients that deferred care will drive increased demand for the foreseeable future.