COVID 19 Salgını Sırasında Omurga Cerrahisi Orta Anadolu da Bir Travma Merkezi Deneyimi

Anatolia Abstract Aim The COVID-19 has affected all aspects of public health. In order to preserve valuable medical resources, most health care systems have halted elective and non-essential surgeries. Spine surgery is no exception in this period. However, defining essential and non-essential surgeries, the management of patients and due screening process has made a clear algorithm a must. Material and Methods The patients operated for various spinal surgeries during a 9-month period at an only reference trauma and spinal surgery performing secondary step state hospital in Central Anatolia were evaluated. During this time period, a guideline in discriminating essential surgeries, handling the pre and post-operative course based on previous publications and recommendations was formed. Results During this period 70 spinal surgeries were performed. The patients were categorized into 2 groups; 1- no to low risk and 2- high risk to definite group. Each group of patients underwent distinct process during their hospital stay in order to minimize the risk of contamination. No patient operated on was diagnosed with COVID-19 during their hospital stay or 10 days following their discharge. Conclusion The COVID-19 pandemic is an ongoing process. Numerous centers have shared their experiences while still fighting the contagion. This paper aimed to share an experience of a single trauma hospital of a city serving a population more than 250,000. Numerous more studies based on evidence based medicine are needed to frame a golden standard approach for surgical candidates during the pandemic.

Anahtar Kelimeler:

pandemic, essential, spine surgery

Spine Surgery during the COVID-19 Pandemic: One Trauma Center Experience in Central Anatolia

Abstract Aim The COVID-19 has affected all aspects of public health. In order to preserve valuable medical resources, most health care systems have halted elective and non-essential surgeries. Spine surgery is no exception in this period. However, defining essential and non-essential surgeries, the management of patients and due screening process has made a clear algorithm a must. Material and Methods The patients operated for various spinal surgeries during a 9-month period at an only reference trauma and spinal surgery performing secondary step state hospital in Central Anatolia were evaluated. During this time period, a guideline in discriminating essential surgeries, handling the pre and post-operative course based on previous publications and recommendations was formed. Results During this period 70 spinal surgeries were performed. The patients were categorized into 2 groups; 1- no to low risk and 2- high risk to definite group. Each group of patients underwent distinct process during their hospital stay in order to minimize the risk of contamination. No patient operated on was diagnosed with COVID-19 during their hospital stay or 10 days following their discharge. Conclusion The COVID-19 pandemic is an ongoing process. Numerous centers have shared their experiences while still fighting the contagion. This paper aimed to share an experience of a single trauma hospital of a city serving a population more than 250,000. Numerous more studies based on evidence based medicine are needed to frame a golden standard approach for surgical candidates during the pandemic.

Keywords:

COVID-19; pandemic; essential; elective; spine surgery,

PDF

___

References 1. Agyeman AA, Chin KL, Landersdorfer CB, Liew D, Ofori-Asenso R: Smell and Taste Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis. Mayo Clin Proc 95(8):1621-1631, 2020 doi: 10.1016/j.mayocp.2020.05.030.
2. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, Tao Q, Sun Z, Xia L: Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology 296(2): E32-E40, 2020 doi: 10.1148/radiol.2020200642.
3. Bono CM, Dohring EJ, Finkenberg JG, Ghogawala Z, Kauffman CP, Kreiner S, O'Brien DR, Reiter MF, Reitman CA, Schneider PL, Sullivan WJ, Truumees E, Wang JC. NASS guidance document on elective, emergent and urgent procedures [NASS Website]. April 22, 2020. Available at: https://www.spine.org/Portals/0/assets/downloads/Publications/NASSInsider/NASSGuidanceDocument040320.pdf Accessed December 2, 2020
4. Ghebreyesus TA. WHO Director-General's opening remarks at the media briefing on COVID-19 [World Health Organization Website]. March 11, 2020. Available at: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 Accessed December 1, 2020
5. Jain NS, Alluri RK, Schopler SS, Hah R, Wang JC: COVID-19 and Spine Surgery: A Review and Evolving Recommendations. Global Spine J ;10(5):528-533, 2020 doi:10.1177/2192568220923655
6. Luo L, Liu D, Liao X, Wu X, Jing Q, Zheng J, Liu F, Yang S, Bi B, Li Z, Liu J, Song W, Zhu W, Wang Z, Zhang X, Chen P, Liu H, Cheng X, Cai M, Huang Q, Yang P, Yang X, Han Z, Tang J, Ma Y, Mao C: Modes of contact and risk of transmission in COVID-19 among close contacts. medRxiv 2020.03.24.20042606; doi: https://doi.org/10.1101/2020.03.24.20042606
7. Rizkalla JM, Hotchkiss W, Clavenna A, Dossett A, Syed IY: Triaging Spine Surgery and Treatment during the COVID-19 Pandemic. J Orthop: 20:380-385, 2020 doi:10.1016/j.jor.2020.06.015
8. Soffin EM, Reisener MJ, Sama AA, Beckman JD, Liguori GA, Lebl DR, Girardi FP, Cammisa FP, Hughes AP: Essential Spine Surgery During the COVID-19 Pandemic: A Comprehensive Framework for Clinical Practice from a Specialty Orthopedic Hospital in New York City. HSS J: 16(Suppl 1):1-7, 2020 doi:10.1007/s11420-020-09786-0
9. Tamburrelli FC, Meluzio MC, Perna A, Santagada DA, Genitiempo M, Zirio G, Proietti L: Spinal surgery in COVID-19 pandemic era: One trauma hub center experience in central-southern Italy. J Orthop: 15;22:291-293, 2020 doi: 10.1016/j.jor.2020.06.014
10. Tekin A. Postponement of Elective Transactions and Other Measures to be Taken [Republic of Turkey, Ministry of Health]. March 17, 2020. Available at: https://hasta.saglik.gov.tr/Eklenti/36865/0/elektif-islemlerin-ertelenmesi-ve-diger-tedbirlerpdf.pdf Accessed December 1, 2020
11. Verma V, Nagar M, Jain V, Santoshi JA, Dwivedi M, Behera P, Selvanayagam R, Pal D, Singh K: Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital. Cureus: 12(7):e9147, 2020 doi:10.7759/cureus.9147
12. Watson J, Whiting PF, Brush JE: Interpreting a covid-19 test result. BMJ: 369:m1808, 2020 doi: 10.1136/bmj.m1808. PMID: 32398230.
13. Wong J, Goh QY, Tan Z, Lie SA, Tay YC, Ng SY, Soh CR: Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore. Can J Anesth/J Can Anesth: 67, 732–745, 2020 doi: 10.1007/s12630-020-01620-9