Tanaka Masaru, Kanayama Masahiro, Hashimoto Tomoyuki, Oha Fumihiro, Shimamura Yukitoshi, Tsujimoto Takeru, Hasegawa Yuichi, Nojiri Hidetoshi, Ishijima Muneaki
Spine Center, Hakodate Central General Hospital, Hokkaido, Japan.
Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Spine Surg Relat Res. 2022 Feb 10;6(2):109-114. doi: 10.22603/ssrr.2021-0208. eCollection 2022.
In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, the importance of triaging surgeries was suggested to reduce burdens on the existing health system and maintaining service. The governor declared a state of emergency and requested that residents avoid going out unnecessarily (semi-lockdown) for the entire prefecture including our medical region from February 28 until May 25, 2020. However, for several spine patients, a significant delay in care may result in the progression of extremity weakness and pain. This study aimed to investigate trends of spine surgeries during the first COVID-19 semi-lockdown in the nonepidemic region in Japan.
Spine surgeries performed in our institution from February 28 until May 25 between 2017 and 2020 were retrospectively reviewed and analyzed. We compared the number of spine surgeries and types of surgical spine pathologies between 2017 and 2019: previous years and 2020: a COVID-19 year.
The mean number of spine surgeries performed in previous years was 121 cases, and the number of spine surgeries performed in a COVID-19 year was 109 cases. The percentage of urgent surgeries was 19.6% in previous years versus 37.6% in a COVID-19 year; the difference was statistically significant (P<0.05). Among the urgent surgical spine pathologies, the prevalence of cauda equina or severe nerve root compression leading to progressive neurological deterioration or intractable pain was 20.2% in a COVID-19 year, which was significantly higher than 12.4% in previous years (P<0.05).
The first COVID-19 semi-lockdown in Japan led to a decrease in elective cases and an increase in urgent cases and might affect progressive neurological deterioration for some spine patients even in a nonepidemic region.
在2019年冠状病毒病（COVID-19）大流行的早期阶段，有人提出对手术进行分类的重要性，以减轻现有卫生系统的负担并维持服务。2020年2月28日至5月25日，州长宣布进入紧急状态，并要求包括我们医疗区域在内的整个县的居民避免不必要外出（半封锁）。然而，对于一些脊柱疾病患者，护理的显著延迟可能导致肢体无力和疼痛的进展。本研究旨在调查日本非流行地区首次COVID-19半封锁期间脊柱手术的趋势。
回顾性分析2017年至2020年2月28日至5月25日在我们机构进行的脊柱手术。我们比较了2017年至2019年（前几年）和2020年（COVID-19年）脊柱手术的数量以及手术脊柱病变的类型。
前几年进行的脊柱手术平均数量为121例，COVID-19年进行的脊柱手术数量为109例。前几年紧急手术的比例为19.6%，而COVID-19年为37.6%；差异具有统计学意义（P<0.05）。在紧急手术脊柱病变中，马尾神经受压或严重神经根受压导致进行性神经功能恶化或顽固性疼痛的患病率在COVID-19年为20.2%，显著高于前几年的12.4%（P<0.05）。
日本首次COVID-19半封锁导致择期病例减少，紧急病例增加，即使在非流行地区，也可能影响一些脊柱患者的进行性神经功能恶化。
