Coronavirus disease 2019 (COVID-19) has rapidly become a ubiquitous health concern and a global pandemic. In an effort to slow disease spread and protect valuable healthcare resources, cessation of non-essential surgery including many orthopaedic procedures, has recently become commonplace in areas affected by the novel coronavirus. This crisis has created a unique situation in the care of spine patients as we must balance the urgency of patient evaluation, surgical intervention, and continued training against the risk of disease exposure and resource management.
The Spine division of an Orthopaedic Surgery Department at a tertiary care and academic center has taken an active role in enacting protocol changes in anticipation of COVID-19. In the past four weeks, since these changes were enacted, the Spine division has performed ten surgeries compared to an average of 60.4 spine cases performed annually over the same time period between 2015-2019. Furthermore, the number of clinic visits decreased from an average of 417.4 over this time period, to 322 with the percentage of new patient visits decreasing from 28% to 20%. During COVID-19, 318 of the 322 spine clinic visits were performed remotely via telehealth.
The response to COVID-19 has been variable among surgical subspecialties and geographic regions. We present the changes that have been made regarding the care of spine patients at a busy academic center. Although these changes have been forced upon us by necessity, we feel that our division and department will emerge in a more responsive, agile and stronger state. As we look to the coming months and beyond, it will be important to continue to adapt to the changing landscape during unprecedented times.