Spinal surgery during the COVID-19 pandemic: the experience in a tertiary referral centre.

Riley, James; Verma, Rajat

Background The COVID-19 pandemic first came to prominence in December 2019, and since then has swept the globe, causing one of the largest public health problems seen. It has had a wide-ranging impact on healthcare provision, with a cessation of elective operating. We aimed to assess the impact of COVID-19 on a tertiary referral centre for spinal surgery in England. Methods An 82-day study period from 20th March 2020 to 10th June 2020 was used, and all spinal surgical patients were followed up prospectively, comparing patients from the same date range in 2019. We assessed rate of COVID transmission, 30-day mortality rates, complication rates and length of hospital stay in a large tertiary Teaching hospital in England. Results Seventy-eight patients were operated on during the COVID-19 pandemic period, with a 30-day mortality rate of 4.2%. Two of these deaths were attributable to COVID-19 (2.56%). The mean length of stay was 10.8 days. Neither the 30-day mortality rate or the length of stay was statistically significant compared to the 2019 control period. Five patients (6.4%) tested positive for COVID-19, all were negative at time of surgical intervention. Our complication rate was 10.3% during the COVID-19 pandemic period. Conclusions The number of operative cases performed during the COVID-19 pandemic fell by one-third compared to the same period in 2019. The COVID-19 pandemic did not cause a significant increase in 30-day mortality rate, length of stay, or complication rates. Further studies with larger patient numbers and longer-term outcomes will be needed to fully assess the impact of the COVID-19 pandemic on spinal surgery.