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The Impact of the SARS-CoV2 Pandemic on Postoperative Outcomes Following Elective Spine Surgery: A Case-Control Study
Amy Z Lu1,2, Lauren A Barber1,3, Tomoyuki Asada1,4
1Department of Spine Surgery, Hospital for Special Surgery.
Study Design:
Retrospective cohort study with matched historical controls.
Objective:
To evaluate postoperative outcomes for patients undergoing elective spine surgery immediately before the suspension of elective procedures due to COVID-19, comparing them to a matched cohort from the same period in 2018.
Summary Of Background Data:
The COVID-19 pandemic significantly disrupted elective surgeries globally. The impact of these disruptions on surgical outcomes, particularly for spine surgery, remains unclear, especially during the height of the pandemic when health care resources were strained.
Methods:
This retrospective study included 60 patients who underwent elective spine surgery between March 1 and 16, 2020, during the initial wave of the COVID-19 pandemic, compared with 60 matched patients from March 1 and 16, 2018. Data were extracted from the institution's electronic health records. Variables analyzed included patient demographics, surgical data, complications, reoperations, follow-up outcomes at 30 days, 90 days, and 2 years, as well as the use of telemedicine for follow-up visits. Outcomes were compared between the 2 cohorts.
Results:
Both groups had similar Charlson comorbidity index scores ( P =0.508). The COVID-19 cohort had a higher proportion of ASA III patients (35% vs. 31.7%) and a significantly higher rate of telemedicine use for follow-up (81.7% vs. 23.3%, P <0.001). There were no significant differences in complications, readmissions, reoperations, or follow-up rates at any time point. Surgical indications differed, with weakness more frequently cited as an indication in the COVID-19 cohort (30% vs. 10%, P =0.014).
Conclusions:
Postoperative outcomes for elective spine surgery during the COVID-19 pandemic did not differ significantly from those observed in a matched cohort from 2018. The use of telemedicine and careful patient selection may have helped mitigate the potential negative effects of the pandemic on surgical outcomes. Further studies are needed to assess longer-term impacts and optimize care during future global crises.
