Abstract：
OBJECTIVE: With resumption of elective spine surgery services in the UK following the first wave of the COVID-19 pandemic, we conducted a multicentre British Association of Spine Surgeons (BASS) collaborative study to examine the complications and deaths due to COVID-19 at the recovery phase of the pandemic. The aim was to analyze the safety of elective spinal surgery during the pandemic.
METHODS: A prospective observational study was conducted from eight spinal centres for the first month of operating following restoration of elective spine surgery in each individual unit. Primary outcome measure was the 30-day postoperative COVID-19 infection rate. Secondary outcomes analyzed were the 30-day mortality rate, surgical adverse events, medical complications, and length of inpatient stay.
RESULTS: In all, 257 patients (128 males) with a median age of 54 years (2 to 88) formed the study cohort. The mean number of procedures performed from each unit was 32 (16 to 101), with 118 procedures (46%) done as category three prioritization level. The majority of patients (87%) were low-medium \"risk stratification\" category and the mean length of hospital stay was 5.2 days. None of the patients were diagnosed with COVID-19 infection, nor was there any mortality related to COVID-19 during the 30-day follow-up period, with 25 patients (10%) having been tested for symptoms. Overall, 32 patients (12%) developed a total of 34 complications, with the majority (19/34) being grade 1 to 2 Clavien-Dindo classification of surgical complications. No patient required postoperative care in an intensive care setting for any unexpected complication.
CONCLUSIONS: This study shows that safe and effective planned spinal surgical services can be restored avoiding viral transmission, with diligent adherence to national guidelines and COVID-19-secure pathways tailored according to the resources of the individual spinal units. Cite this article: Bone Jt Open 2021;2(12):1096-1101.
METHODS: A prospective observational study was conducted from eight spinal centres for the first month of operating following restoration of elective spine surgery in each individual unit. Primary outcome measure was the 30-day postoperative COVID-19 infection rate. Secondary outcomes analyzed were the 30-day mortality rate, surgical adverse events, medical complications, and length of inpatient stay.
RESULTS: In all, 257 patients (128 males) with a median age of 54 years (2 to 88) formed the study cohort. The mean number of procedures performed from each unit was 32 (16 to 101), with 118 procedures (46%) done as category three prioritization level. The majority of patients (87%) were low-medium \"risk stratification\" category and the mean length of hospital stay was 5.2 days. None of the patients were diagnosed with COVID-19 infection, nor was there any mortality related to COVID-19 during the 30-day follow-up period, with 25 patients (10%) having been tested for symptoms. Overall, 32 patients (12%) developed a total of 34 complications, with the majority (19/34) being grade 1 to 2 Clavien-Dindo classification of surgical complications. No patient required postoperative care in an intensive care setting for any unexpected complication.
CONCLUSIONS: This study shows that safe and effective planned spinal surgical services can be restored avoiding viral transmission, with diligent adherence to national guidelines and COVID-19-secure pathways tailored according to the resources of the individual spinal units. Cite this article: Bone Jt Open 2021;2(12):1096-1101.
摘要：
目标：随着第一波COVID-19大流行后英国恢复择期脊柱外科服务，我们进行了一项多中心英国脊柱外科医师协会(BASS)合作研究,以检查COVID-19在大流行恢复期的并发症和死亡情况.目的是分析大流行期间择期脊柱手术的安全性。
方法：在8个脊柱中心进行了一项前瞻性观察性研究，对每个单位的选择性脊柱手术恢复后的第一个月进行了手术。主要结果指标是术后30天COVID-19感染率。分析的次要结果是30天死亡率，手术不良事件，医疗并发症,以及住院时间。
结果：总而言之，257名患者（128名男性），中位年龄为54岁（2至88岁），形成了研究队列。从每个单元执行的程序的平均数量为32（16至101），118个程序(46%)作为第三类优先级别完成。大多数患者（87％）为中低“危险分层”类别，平均住院时间为5.2天。没有患者被诊断为COVID-19感染，在30天的随访期间，也没有任何与COVID-19相关的死亡率，有25名患者（10％）接受了症状测试。总的来说,32例（12%）患者共出现34种并发症，大多数（19/34）为Clavien-Dindo手术并发症的1至2级分类。没有患者需要在重症监护环境中进行任何意外并发症的术后护理。
结论：这项研究表明，可以恢复安全有效的计划脊柱手术服务，避免病毒传播，认真遵守国家指南和根据各个脊柱单元的资源量身定制的COVID-19安全途径。引用这篇文章：BoneJtOpen2021；2（12）：1096-1101。
方法：在8个脊柱中心进行了一项前瞻性观察性研究，对每个单位的选择性脊柱手术恢复后的第一个月进行了手术。主要结果指标是术后30天COVID-19感染率。分析的次要结果是30天死亡率，手术不良事件，医疗并发症,以及住院时间。
结果：总而言之，257名患者（128名男性），中位年龄为54岁（2至88岁），形成了研究队列。从每个单元执行的程序的平均数量为32（16至101），118个程序(46%)作为第三类优先级别完成。大多数患者（87％）为中低“危险分层”类别，平均住院时间为5.2天。没有患者被诊断为COVID-19感染，在30天的随访期间，也没有任何与COVID-19相关的死亡率，有25名患者（10％）接受了症状测试。总的来说,32例（12%）患者共出现34种并发症，大多数（19/34）为Clavien-Dindo手术并发症的1至2级分类。没有患者需要在重症监护环境中进行任何意外并发症的术后护理。
结论：这项研究表明，可以恢复安全有效的计划脊柱手术服务，避免病毒传播，认真遵守国家指南和根据各个脊柱单元的资源量身定制的COVID-19安全途径。引用这篇文章：BoneJtOpen2021；2（12）：1096-1101。
