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Cervical Spine Surgery Following COVID-19 Infection: When is it Safe to Proceed?
- Source :
-
Clinical spine surgery [Clin Spine Surg] 2024 May 01; Vol. 37 (4), pp. 155-163. Date of Electronic Publication: 2024 Apr 19. - Publication Year :
- 2024
-
Abstract
- Study Design: Retrospective.<br />Objective: We utilized the NIH National COVID Cohort Collaborative (N3C) database to characterize the risk profile of patients undergoing spine surgery during multiple time windows following the COVID-19 infection.<br />Summary of Background Data: While the impact of COVID-19 on various organ systems is well documented, there is limited knowledge regarding its effect on perioperative complications following spine surgery or the optimal timing of surgery after an infection.<br />Methods: We asked the National COVID Cohort Collaborative for patients who underwent cervical spine surgery. Patients were stratified into those with an initial documented COVID-19 infection within 3 time periods: 0-2 weeks, 2-6 weeks, or 6-12 weeks before surgery.<br />Results: A total of 29,449 patients who underwent anterior approach cervical spine surgery and 46,379 patients who underwent posterior approach cervical spine surgery were included. Patients who underwent surgery within 2 weeks of their COVID-19 diagnosis had a significantly increased risk for venous thromboembolic events, sepsis, 30-day mortality, and 1-year mortality, irrespective of the anterior or posterior approach. Among patients undergoing surgery between 2 and 6 weeks after COVID-19 infection, the 30-day mortality risk remained elevated in patients undergoing a posterior approach only. Patients undergoing surgery between 6 and 12 weeks from the date of the COVID-19 infection did not show significantly elevated rates of any complications analyzed.<br />Conclusions: Patients undergoing either anterior or posterior cervical spine surgery within 2 weeks from the initial COVID-19 diagnosis are at increased risk for perioperative venous thromboembolic events, sepsis, and mortality. Elevated perioperative complication risk does not persist beyond 2 weeks, except for 30-day mortality in posterior approach surgeries. On the basis of these results, it may be warranted to postpone nonurgent spine surgeries for at least 2 weeks following a COVID-19 infection and advise patients of the increased perioperative complication risk when urgent surgery is required.<br />Competing Interests: The authors declare no conflict of interest.<br /> (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 2380-0194
- Volume :
- 37
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Clinical spine surgery
- Publication Type :
- Academic Journal
- Accession number :
- 38648080
- Full Text :
- https://doi.org/10.1097/BSD.0000000000001609