Document Type

Conference Proceeding

Publication Date

5-2026

Publication Title

Global Spine Journal

Abstract

Introduction: The COVID-19 pandemic caused major disruptions in elective surgical care, including spine surgery, due to widespread hospital restructuring and resource limitations. Although previous studies have examined surgical volumes and safety during the pandemic, limited data exist on how outcomes varied across multiple phases of the pandemic, especially in real-world, multicenter spine surgery populations. Material and Methods: This retrospective cohort study used data from the Michigan Spine Surgery Improvement Collaborative (MSSIC) to compare outcomes in patients undergoing lumbar or cervical spine surgery across four COVID-19 timeframes: pre-COVID (1/2019-2/2020), onset-COVID (3/2020-9/2020), active-COVID (10/2020-2/2022), and post-COVID (3/2022- 12/2022). Patient demographics, surgical characteristics, 30- and 90-day adverse events, and patient-reported outcomes (PROs) were compared across cohorts using Chi-squared or Fisher’s exact tests for categorical variables and ANOVA or Kruskal-Wallis tests for continuous variables. Results: Among 47,831 patients (33,532 lumbar; 14,299 cervical), demographics were consistent across phases. For lumbar surgery, onset-COVID was marked by higher durotomy, urinary retention, and 90-day return-to-OR, while CSF leak and 30-day readmissions declined during active-COVID. Cervical surgery showed increased dysphagia during active-COVID and higher 90-day return-to-OR and readmissions during onset-COVID, with urinary retention rates declining over time. Patient-reported outcomes were generally stable, however, lumbar patients were more likely to achieve back pain MCID during onset-COVID. Notably, cervical patients reported higher one-year satisfaction during onset-, active-, and post-COVID compared with pre-COVID. Functional recovery showed different patterns: lumbar return-to-work dropped at onset but later stabilized, whereas cervical return-to-work stayed consistent across phases and improved post-COVID. Readmission causes also shifted: pulmonary complications increased at onset then decreased, while electrolyte, pharmacologic, and stroke-related readmissions declined over time. Conclusion: Spine surgery outcomes remained largely stable throughout the COVID-19 pandemic. Although certain complications temporarily increased during the onset phase, outcomes normalized as healthcare systems adapted. Long-term patient-reported outcomes were not adversely impacted and, in some cases, improved, suggesting resilience in surgical care delivery despite pandemic-related challenges.

Volume

16

Issue

2 Suppl

First Page

746S

Comments

Global Spine Congress, May 27-30, 2026, Istanbul, Turkey

Last Page

746S

DOI

10.1177/21925682261435811

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Orthopedics Commons

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