Singh Binoy K, Dey Biswajit, Boruah Deb K, Mukherjee Aishik, Kumar Sumit, Sharma Manoranjan, Phukan Pranjal
Neurosurgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND.
Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND.
Cureus. 2021 Dec 9;13(12):e20287. doi: 10.7759/cureus.20287. eCollection 2021 Dec.
There has been a drastic reduction in the number of neurosurgeries performed during the COVID-19 pandemic due to a multitude of challenges prompting restructuring of neurosurgical services. The present study describes the challenges and outcomes of non-elective neurosurgical procedures done on COVID-19 positive patients along with the modifications in neurosurgical practice during the pandemic.
A retrospective study was done in the Department of Neurosurgery over a period of one year and three months. Demographic and clinical details including outcomes of the COVID-19 positive patients, who had undergone non-elective neurosurgical interventions, were collected.
Ten patients (3.8%) were COVID-19 positive out of 262 neurosurgical interventions done. The age of the patients ranged from 5 days to 78 years with five males and five females. Out of the 10 patients, five were neurotrauma cases including one patient of head injury with craniovertebral junction injury. The patient with craniovertebral junction injury underwent foramen magnum decompression with C1 lateral mass-C2 pedicle screw on the right and C0-C2 pedicle screw and rod fixation on the left. The rest of the neurotrauma cases underwent craniotomy or burr-hole craniostomy followed by evacuation. Only one patient (10%) had postoperative 30-day mortality. The rest nine patients (90%) survived the post-operative 30-day mortality. The various modifications incorporated in the neurosurgical practice included categorizing the emergency room into various zones, a separate operating theatre for COVID-19 patients, limiting the number of operating members as well as minor modifications in the operating procedures.
The postoperative surgical outcome is favorable in COVID-19 positive patients with modifications of the existing neurosurgical practices.
由于众多挑战促使神经外科服务进行重组，在新冠疫情期间进行的神经外科手术数量急剧减少。本研究描述了对新冠阳性患者进行的非选择性神经外科手术的挑战和结果，以及疫情期间神经外科实践的改变。
在神经外科进行了一项为期一年零三个月的回顾性研究。收集了包括接受非选择性神经外科干预的新冠阳性患者的人口统计学和临床细节以及结果。
在262例神经外科手术中，10例患者（3.8%）新冠阳性。患者年龄从5天至78岁不等，男性5例，女性5例。在这10例患者中，5例为神经创伤病例，包括1例合并颅颈交界损伤的头部损伤患者。该颅颈交界损伤患者接受了枕骨大孔减压术，右侧行C1侧块-C2椎弓根螺钉固定，左侧行C0-C2椎弓根螺钉及棒固定。其余神经创伤病例接受开颅手术或钻孔开颅术，随后进行血肿清除。只有1例患者（10%）术后30天死亡。其余9例患者（90%）术后30天存活。神经外科实践中纳入的各种改变包括将急诊室划分为不同区域、为新冠患者设立单独的手术室、限制手术人员数量以及对手术程序进行微小改变。
通过对现有神经外科实践进行调整，新冠阳性患者的术后手术结果良好。
