Challenges and management of spine trauma during Covid-19

Abstract

The COVID-19 pandemic is the most serious threat to national health systems in a century. The rapid development and spread of the COVID-19 disease necessitated a significant shift in clinical practice and a restructuring of institutional structures. Elective surgery has been drastically reduced in Spinal Surgery Units around the world since the start of the pandemic, and spine trauma management techniques have changed dramatically. All elective treatments, including spinal surgeries, were cancelled due to the virus's highly contagious nature, reduced nosocomial infection, and freed up extra beds for COVID-19 diseases. Emergencies, such as growing neurological deficits or spine instability caused by fractures, infections, or malignancies, could not be postponed. While different considerations should have been made before performing routine spine procedures, the latter was rendered more difficult due to unknown characteristics of the COVID-19 infection. In one study, all patients were polytrauma patients with a higher risk of pneumonia complications due to trauma. The usefulness of corticosteroids in the treatment of spinal cord injury is debated. In the instance of COVID-19 infection, Russell et al. advised not to use corticosteroids. Pneumonia was linked to a 20percent increase in death rate following posterior lumbar fusion surgeries in research by Bohl et al.