Payton Olivia, Prakash Rohan, Shaikh Adnan, Hassan Md Faizul, Haleem Shahnawaz
Spinal Surgery, Royal Orthopaedic Hospital, Birmingham, GBR.
Cureus. 2023 Dec 24;15(12):e51017. doi: 10.7759/cureus.51017. eCollection 2023 Dec.
The aim of this study was to assess the safety of our spinal surgery pathways for patients over the age of 70 years during the COVID-19 pandemic, to guide future management.
A retrospective, single-centre, observational cohort study of all patients over 70 years of age undergoing spinal surgery between June 1 to September 30, 2020, was performed. All patients were stratified by the British Orthopaedic Association (BOA) COVID-19 Patient Risk Assessment Tool.
A total of 64 operations on 59 patients were performed. The BOA risk assessment placed 67.8% of patients (n=40) in the high or very high-risk category. A total of 60% of patients (n=36) were over 75 years old. All patients had at least one other comorbidity. Following our green, amber, and red pathways, we had no cases of post-operative COVID-19 on an average follow-up of 71 days.
Our study illustrates safe pathways for spinal surgery on patients over 70 years old during the first wave of COVID-19. Risk assessment tools should be used with caution, as age over 65 years was immediately medium-risk. This study would be a useful guide in the management of all elderly patients requiring surgery in the face of further COVID-19 variants or a similar pandemic.
本研究旨在评估在新冠疫情期间，我们为70岁以上患者开展脊柱手术路径的安全性，以指导未来的管理工作。
对2020年6月1日至9月30日期间接受脊柱手术的所有70岁以上患者进行了一项回顾性、单中心观察性队列研究。所有患者均通过英国骨科协会（BOA）新冠患者风险评估工具进行分层。
共对59例患者进行了64台手术。BOA风险评估将67.8%的患者（n = 40）归为高风险或极高风险类别。共有60%的患者（n = 36）年龄超过75岁。所有患者都至少有一种其他合并症。遵循我们的绿色、琥珀色和红色路径，在平均71天的随访中，我们没有出现术后新冠病例。
我们的研究表明，在新冠疫情第一波期间，为70岁以上患者进行脊柱手术有安全的路径。风险评估工具应谨慎使用，因为65岁以上即刻属于中度风险。面对新冠病毒的进一步变异或类似疫情，本研究将为所有需要手术的老年患者的管理提供有益指导。
