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The impact of the first year of COVID-19 pandemic on volume of spine surgery in Germany – a DWG-registry analysis
Der Einfluss des ersten Jahres der COVID-19-Pandemie auf das Volumen der Wirbelsäulenchirurgie in Deutschland – eine DWGRegisteranalyse
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Veröffentlicht: | 25. Mai 2022 |
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Objective: Medical care in Germany changed markedly during the first year of the COVID-19 pandemic. The impact of the pandemic on surgical spine care in Germany, however, has not been investigated in a multicentre setting yet. It was hypothesized that the COVID-19 pandemic in Germany is associated with a reduction of executed surgical spinal interventions, which was more prominent in specific categories of interventions.
Methods: The German Spine Registry (DWG Register) was utilized and surgical cases between 01.01.2019 and 31.12.2020 were selected. Two groups were composed. Patients enrolled prior to the start of the COVID-19 pandemic (before 01.01.2020) were included in group ‘PRE-pandemic’. Patients admitted between 01.01.2020 and 31.12.2020 were selected for the group ‘PANdemic’. The number of performed interventions for different categories of spinal pathologies were compared between PRE-pandemic and PANdemic conditions. Hospitals participating in both study periods have been included.
Results: A total of 96 institutions and 96,243 cases were included. Annual interventions per institution was higher in the PRE-pandemic-group, compared with the PANdemic group (respectively 453 vs. 428 surgeries/institution. Moreover, in the PANdemic-group, the number of executed surgeries was significantly decreased in the month April, compared with the reference year 2019 (PRE-Group), p=0,031. As anticipated, the most prominent decrease of executed surgeries was seen in patients with degenerative diseases. In addition, a striking drop of performed interventions for critical categories such as infection and tumours occurred in both the 1st and 2nd pandemic waves as well.
Conclusion: The current study demonstrates that the COVID-19 pandemic is associated with a radical reduction of performed spinal surgeries in Germany. During periods of peak COVID-19 incidences not only a decrease in performed elective surgeries was seen, but also the number of interventions for critical conditions dropped markedly. This indicates that patient groups with critical spinal diseases have been undersupplied during the first year of the COVID-19 pandemic in Germany. Additional in-depth evaluation of surgical spine care for specific spinal pathologies during the COVID-19 is mandated to optimize triage and patient distribution protocols.