World Spine Day 2021- Back2Back
On this world spine day, we are slowly limping back to normal from the consequences of the COVID pandemic. Health care is moving towards elective issues that had been ignored in the lockdowns. The turmoil caused by fear of the dreaded virus has led to some unique problems. Patients who require surgery for conditions where nonoperative treatment has failed usually undergo a pre-operative COVID swab test as well as if required, a CT chest.
The new normal has relegated people to working from home with no standardized work hours, higher than normal workloads, and very few avenues for leisure and social life. This combined with the constant fear of contracting the virus as well as the relentless alarmist news distributed through social media has led to high degrees of stress and anxiety in all populations. Homemakers are under the constant stress of children being at home and online classes. These factors have led to patients presenting with multiple pains predominantly related to the low back and neck and sometimes headaches. Once you can get it cleared with your spine surgeon then the answer for these pains is in searching for a balanced lifestyle with not just physical health but also emotional and mental peace. Yoga, meditation, exercise, and adequate social interaction with good sleep is the remedy.
However, what if your pain is actually due to a pathological issue? Pains due to degeneration of the spine, disc prolapse, and other issues due to wear and tear of the spine are usually self-limiting and very few of them require surgery or intervention. Most of them settle with rest and painkillers. What has changed is the fear of patients seeking medical advice and treatment during the active waves of Covid 19. There was also significant fear of getting operated on under these circumstances. At the current point in time, there is adequate scientific evidence and experience to make well-informed decisions and plan treatment for these non-emergent conditions. Clearly, hospitals have taken to very robust protocols to prevent the spread of the disease inside the hospital, including testing of patients and attenders and CT screening of high-risk patients. Your doctor will actively dissuade you from nonemergent surgery if they feel that you are at risk of Covid.
In patients who require surgery for conditions where nonoperative treatment has failed usually undergo a pre-operative COVID swab test as well as if required, a CT chest. Patients who turn out to be positive may require the surgery to be postponed. Patients who have recently recovered from COVID may require certain additional investigations prior to being posted for surgery.
In the unfortunate case, that a patient has active COVID infection but still requires emergency surgery for either infection or fractures of the spine. The patient is informed about the possibilities of worsening of the covid status as well an increased risk of complications including bleeding and infection. Most hospitals that do these surgeries have separate operation theatres for the same with isolated wards and extra protective equipment. Your surgeon and anesthetist are best equipped to advise you regarding the risks and benefits of the situation.
Be safe, mask up, and always get the best possible advice from your surgeon rather than following ill-informed social media opinions.
Safe spine surgery is a reality but it comes with experience and expertise.
Dr. Parthasarathy Srinivasan
Orthopedic Surgeon and Spine Specialist
Dr. Mehta’s Hospitals.