Impact of the COVID-19 pandemic on surgical volume and outcomes in spine surgery: a multicentre retrospective study in Tokyo.

Publication date: Nov 29, 2023

To investigate the effect of the COVID-19 pandemic on surgical volume and outcomes in spine surgery. A retrospective cohort study using prospectively collected data. A total of 9935 patients who underwent spine surgery between January 2019 and December 2021 at eight high-volume spine centres in the Greater Tokyo metropolitan area were included. The primary outcome measures were the number of surgical cases, perioperative complications and patient-reported outcomes, including numerical rating scales for each body part, Euro quality of life 5-dimension (EQ5D), Neck Disability Index and Oswestry Disability Index (ODI). The total number of surgeries in 2020 and 2021 remained lower than that of 2019, with respective percentages of 93. 1% and 95. 7% compared with the prepandemic period, with a marked reduction observed in May 2020 compared with the same period in 2019 (56. 1% decrease). There were no significant differences between the prepandemic and postpandemic groups in the incidence of perioperative complications, although the frequency of reoperation tended to be higher in the postpandemic group (3. 04% vs 3. 76%, p=0. 05). Subgroup analysis focusing on cervical spine surgery revealed significantly worse preoperative EQ5D scores in the postpandemic group (0. 57 vs 0. 54, p=0. 004). Similarly, in lumbar spine surgery, the postpandemic group showed higher levels of leg pain (5. 7 vs 6. 1 to 0. 002) and worse ODI scores (46. 2 vs 47. 7 to 0. 02). However, postoperative outcomes were not different between pre and post-pandemic groups. The COVID-19 pandemic has significantly impacted spinal surgeries in Japan, leading to a decrease in surgical volumes and changes in patient characteristics and surgical procedures. However, surgical outcomes remained comparable between the pre and postpandemic periods, indicating the resilience and adaptability of healthcare systems.

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Concepts Keywords
Japan Quality of Life
Odi Spine


Type Source Name
disease MESH COVID-19 pandemic
disease VO volume
disease MESH complications
disease IDO quality
disease VO frequency
disease MESH infection
disease MESH emergency
disease VO effective
drug DRUGBANK Coenzyme M
disease VO USA
drug DRUGBANK Spinosad
disease IDO facility
disease MESH rheumatoid arthritis
pathway KEGG Rheumatoid arthritis
disease MESH Postoperative complications

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