Medical Student All Saints University SOM Roseau, DM
Introduction: The COVID-19 pandemic disrupted healthcare, leading to delays and adjustments in neurosurgical services, particularly elective spine surgeries. This systematic review compares surgical outcomes in spine surgery before and during the pandemic (2020), focusing on patient outcomes, complications, and recovery, and highlights the clinical implications of the pandemic on spine surgery.
Methods: A comprehensive search of PubMed, Google Scholar, Cochrane, and Scopus was conducted following PRISMA guidelines.
Results: A total of 33 retrospective studies from 15 countries were included, analyzing 55,331 pre-pandemic patients and 40,518 pandemic patients. The mean age was 57.20 years pre-pandemic and 54.04 years during the pandemic. The percentage of male patients was 51.62% pre-pandemic and 56.33% during the pandemic. A higher percentage of patients presented with motor weakness in the pre-pandemic group compared to the pandemic group (49.61% vs 23.32%, p=0.025). The mean preoperative VAS for pain was higher in 2020 compared to pre-pandemic (9.09 vs. 7.30, p< 0.001), as was the mean postoperative VAS (3.67 vs. 1.90, p< 0.001)
The Glasgow Outcome Scale Extended (GOS-E) was comparable between groups (pre-pandemic: 6.67, pandemic: 6.50, p = 0.767). There were no significant differences in surgery duration, intraoperative blood loss, complications, mortality, reoperation rates, length of stay, readmissions, or 30-day readmissions (p>0.05). Rate of surgical site infection was similar, with rates of 15.92% pre-pandemic and 14.78% during the pandemic (p=0.927)
Conclusion : Spine surgery outcomes before and during the pandemic were largely similar, with no significant differences in complications, mortality, or recovery. However, pain levels and motor weakness were higher during the pandemic, reflecting delays and challenges in timely care during COVID-19. The long-term consequences of this delay need to be further explored.
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