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. 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.Aims
Methods
Back pain affects 70% of the population in developed countries and accounts for 13% of sickness absence in the United Kingdom1. The clinical presentation might be taken less seriously and could result in significant morbidity and mortality. We did a retrospective observational study of patients admitted on an “acute” basis in our unit. Our aim was to identify the epidemiological proportion of patients who had significant life changing spinal conditions. 239 patients were admitted between January 2004 to December 2008 who presented with non traumatic back pain and related symptoms. The group of patients who had osteoporotic compression fractures were excluded. The mean age was 53.6 and patients were predominantly females. Disc protrusions and degenerative conditions accounted for majority of the patients. Cauda Equina Syndrome (CES) and Cord compressions together contributed to 7.9% and 8.7% respectively. The mean length of stay was 10.4 days and the average wait for MRI scan was 2.4 days. Among the patients who present with back pain in the primary care setting, 3% have disc protrusions and 1% neoplastic lesions1. But the epidemiological distribution among the back pain admissions in the hospital setting is not very clear. Medico legal costs especially with CES are quite substantial2 and hence it would be useful to know the volume of patients with potential disabling lesions. Our study reveals that a significant proportion of patients who had to be admitted with back pain and especially those having red flag signs have serious spinal pathologies. Early diagnosis and timely intervention could prevent unwarranted morbidity and mortality.
