ABSTRACT
Documented re-infection of COVID-19 is uncommon and doing a major spinal surgery in an elderly patient right after the recovery from the first event is itself a major undertaking. Re-infection after successful surgery points to the possibility of COVID-19 infection being a post-surgical complication. Here, we report a case of a 72-years-old elderly female who had presented to us with features of COVID-19 infection confirmed by reverse transcription polymerase chain reaction assay and unstable spinal fracture who underwent a pedicle screw fixation for the fracture of the third and fourth thoracic vertebrae after two consecutive negative serology assays. A month after discharge from the hospital, she presented with severe symptoms of COVID-19 again confirmed by two consecutive polymerase chain reaction assays. She was managed conservatively and was discharged without significant respiratory and neurological complications. We described this case in detail in addition to reviewing the pertinent literature.
Subject(s)
COVID-19 , Pedicle Screws , Spinal Fractures , Aged , Female , Fracture Fixation, Internal/adverse effects , Humans , Lumbar Vertebrae/injuries , Lumbar Vertebrae/surgery , Pedicle Screws/adverse effects , SARS-CoV-2 , Spinal Fractures/etiology , Spinal Fractures/surgery , Thoracic Vertebrae/injuries , Thoracic Vertebrae/surgery , Treatment OutcomeSubject(s)
Coronavirus Infections/epidemiology , Fracture Fixation, Internal/methods , Fractures, Compression/surgery , Pneumonia, Viral/epidemiology , Spinal Fractures/surgery , Vena Cava Filters , Venous Thrombosis/diagnostic imaging , Accidental Falls , Adult , Aged , COVID-19 , Cervical Vertebrae/injuries , Feasibility Studies , Follow-Up Studies , Fractures, Compression/diagnostic imaging , Humans , Injury Severity Score , Lumbar Vertebrae/injuries , Magnetic Resonance Imaging/methods , Male , Pandemics , Point-of-Care Testing , Prosthesis Implantation/methods , Risk Assessment , Spinal Fractures/diagnostic imaging , Taiwan , Tomography, X-Ray Computed/methods , Treatment Outcome , Ultrasonography, Interventional/methods , Venous Thrombosis/therapyABSTRACT
Since December 2019, COVID-19, an acute infectious disease, has gradually become a global threat. We report a case of thoracolumbar fractures (T12 and L1) and incomplete lower limb paralysis in a patient with COVID-19. After a series of conservative treatment which did not work at all, posterior open reduction and pedicle screw internal fixation of the thoracolumbar fracture were performed in Wuhan Union Hospital. Three weeks later, the patient could stand up and the pneumonia is almost cured. We successfully performed a surgery in a COVID-19 patient, and to our knowledge it is the first operation for a COVID-19 patient ever reported.
Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Lumbar Vertebrae/injuries , Paralysis/surgery , Pneumonia, Viral/complications , Spinal Fractures/surgery , Thoracic Vertebrae/injuries , COVID-19 , Fracture Fixation, Internal , Humans , Lumbar Vertebrae/surgery , Male , Middle Aged , Pandemics , Pedicle Screws , SARS-CoV-2 , Thoracic Vertebrae/surgeryABSTRACT
In December 2019, the 2019 novel coronavirus (SARS-CoV-2) began spreading in China. At present, there are no special protocols for treating lumbar burst fracture (LBF) patients infected with SARS-CoV-2. Here, we present our lessons and experiences with a patient presenting with a severe LBF complicated by an occult SARS-CoV-2 infection. The clinical data for a 52-year-old male LBF patient were collected during the incubation period of COVID-19. The patient exhibited no obvious COVID-19-related symptoms prior to his surgery, and his vital signs were stable on the first day after the operation. By postoperative day 3, however, the patient was exhibiting chills and high fever. A chest CT showed a patchy high-density shadow surrounded by ground-glass opacity in the lower portion of his right lung. A nucleic acid test for SARS-CoV-2 was positive, and the patient was then transferred to the Department of Infectious Disease for further special treatment. This case taught that when treating patients with severe trauma within an epicenter of this pandemic, it is crucial for healthcare workers to be vigilant so as to avoid potential widespread outbreaks of COVID-19 within hospitals.