Emergent spine surgery during COVID-19 pandemic: 10 Months experience in Dr. Sardjito general hospital, Indonesia a case series

BACKGROUND: During the COVID-19 pandemic, the spine surgeon had to deal with some new challenges in treating emergency spine cases. This paper aimed to report our experience with spine emergency surgery during the pandemic, with already limited resources for surgery. METHODS: This was a retrospective, single-center study, involving all patients admitted to our hospital during a period of 1st March – 31(st) December 2020 and underwent emergent spinal surgery. The data were collected from the patients’ medical records. RESULTS: We found 15 patients who met the inclusion criteria. Four patients were suspected to be infected by COVID-19, but none of them was confirmed to be infected by COVID-19 based on the PCR test. All patients had a history of injury: fell from height (53.3%), traffic accident (40%), and direct trauma (6.7%). The average time interval from injury to hospital admission was 38.6 h, from admission to surgery was 6.3 days, and from injury to surgery was 8.1 days. The patient who was suspected to be infected with COVID-19 has a significantly greater time interval from admission to surgery (p = 0.012). The surgery lasted for 3–6 h, with an average of 4.6 h. The average hospital stay duration was 13.3 days and it has a significant positive correlation with the time interval from admission to surgery (p = 0.001). Three months post-operatively, seven patients experienced an improvement in the Frankel grade, 4 patients had no changes in Frankel grade, and 2 patients died. CONCLUSION: To our experience, the lack of human and material resources during the pandemic caused some delay in surgery. However, surgery performed later than 24 h during the pandemic might still bring benefit to the patient.