ABSTRACT
Introduction: To investigate the effects of the COVID-19 pandemic on epidural steroid injection treatment in elderly patients and to inform our colleagues to take possible precautions concerning treatment strategies. Materials and Methods: Retrospectively, patients who received lumbar epidural steroid injections between January 2019 and March 2021 were included in the study. The procedures performed between January 2019 and January 2020 before the pandemic were classified as Group A, and those performed during the pandemic period between March 2020 and March 2021 were classified as Group B. Demographic data, baseline pain scores, and waiting times for procedures and medical treatments in both groups were compared. Results: There were 186 and 81 patients in groups A and B, respectively. The mean age was 74 in Group B and 73 in Group A. Lumbar spinal stenosis and disc herniation were the most common diagnoses in both groups. The waiting time for epidural steroid injection was 39.4 days (0–160) in group B and 23.4 days (0–149) in group A. There was no significant difference between the two groups in terms of medical treatment for neuropathic pain. Conclusions: COVID-19 has caused a significant decrease and delay in the number of epidural procedures related to lower back pain in elderly patients. In the future, this decrease may create a burden on the health system. However, more observational and prospective studies are needed to inform our colleagues about the possible effects of COVID-19 on the elderly.
ABSTRACT
Introduction: COVID-19 occurred in late 2019 and subsequently spread globally, resulting in the declaration of the pandemic by the World Health Organization in March 2020. As a results, the increase in patients with COVID-19 affected general practice and reduced the number of outpatients due to patients' avoidance of consultation. The purpose of this study was investigating the influence of COVID-19 on patients underwent lumbar spine surgery at our hospital. Material and Methods: We retrospectively reviewed the medical records of patients who underwent thoracolumbar and lumbar spine surgery in our hospital from April 2019 to March 2021. The cohort was divided into two group according to before or after the pandemic of COVID-19. The number of outpatients and surgeries were counted in each group. From the medical records, information about age, gender, waiting period to the surgery and diseases for which surgery is required. The low back pain and leg pain were assessed using visual analogue scale (VAS) at the admission and discharge, respectively. Oswestry Disability Index (ODI) was measured to evaluate the functional disability at the admission and discharge. Results: The total number of outpatients and surgeries decreased after the pandemic of COVID-19, respectively (Pre-pandemic group: 17635 and 588, post-pandemic group: 15407 and 530). The mean ages in the pre-pandemic group and post-pandemic group were 64.5 years and 63.9 years, respectively, and there was no significant difference between two groups (P = 0.51). The waiting period to the surgery was significantly shorter in the post-pandemic group (35.8 days) than the pre-pandemic (45.6 days) (p < 0.01). The rate of patients with the lumbar herniation increased from 32% to 37% after the pandemic. In the total cohort, the averages of the VAS for the lower back pain, the VAS for the leg pain and ODI were higher in the post-pandemic group, however, there was no significant difference between two groups (Table 1). The VAS and ODI categorized by the disease are summarized in the (Tables 2 and 3) In patients with the lumbar herniation, the post-pandemic group had the significantly higher score in the preoperative VAS for leg pain (P = 0.02). On the other hand, the degenerative diseases included lumbar spinal canal stenosis and degenerative spondylolisthesis had no significant difference in VAS and ODI between the pre-pandemic and post-pandemic group. Conclusion: The number of outpatients in our hospital decreased due to the impact of COVID-19, resulting in the decrease of the lumber surgeries. Although the total cohort had no significant difference in VAS and ODI between the pre-pandemic and post-pandemic group, the patient with lumbar herniation had higher score of the preoperative VAS for the leg pain in post-pandemic group, indicating that COVID-19 could influenced the patients with lumbar herniation than the degenerative diseases. However, according to the postoperative VAS and ODI, it was considered that the COVID-19 didn't affect the prognosis after the surgery in the field of lumbar spine diseases. Table 1 Pre-Post Pandemic VAS and ODI.Table 1 Pre-Post Pandemic VAS and ODI. View larger version Table 2 Pre-Post Pandemic VAS and ODI in Lumbar Herniation Group.Table 2 Pre-Post Pandemic VAS and ODI in Lumbar Herniation Group. View larger version Table 3 Pre-Post Pandemic VAS and ODI in Degenerative Diseases.Table 3 Pre-Post Pandemic VAS and ODI in Degenerative Diseases. View larger version.
ABSTRACT
The new coronavirus disease, which started in Wuhan, quickly transformed into a pandemic and a life-threatening global infection. Understanding Covid-19-specific views can facilitate defining more accurate CT scan diagnostic criteria for this disease. These views include ground-glass opacity (GGO), consolidation, interlobular septal thickening, reticular, and crazy paving. This case series aimed to assess six Covid-19 patients displaying the target sign view in lung CT scans.