An international AO Spine study on the impact of COVID-19 on spine surgeons is having an unprecedented effect on the way pandemics are assessed and managed in the future. Papers have been published in almost every major spine journal at a record speed, and the World Health Organization (WHO) has requested outcomes of the study for future planning. Further prospective studies and guidelines are already in design and they will have a direct impact on health care policy worldwide.
The COVID-19 pandemic has touched everyone around the world, including patients, healthcare workers, and spine surgeons. Every aspect of spine surgery has been affected. An estimated 28.4 million elective surgeries were cancelled or postponed due to the pandemic; over 6 million represent orthopaedic procedures.
"Although many frontline healthcare workers have been particularly impacted, surgeons are often left out of the conversation," AO Spine Research Commission Chairperson, Dino Samartzis says. AO Spine set out to change this with an international research initiative spearheaded by Samartzis. "It was the first in the world to report on the impact of this pandemic among health care workers and to assess regional variations."
"Musculoskeletal diseases/disorders are one of the most common conditions motivating medical consultation worldwide.
Yet, during this period, patients with pain and disability that necessitated immediate intervention could not obtain the medical care they needed, or it was delayed.
Our studies addressing this pandemic brought the global spine community together in an unprecedented fashion."
Samartzis is extremely grateful for the collaborative spirit of AO Spine members and notes that “together we can address impactful research with a global outreach. This is 'team science' at its finest moment. Members of the AO Spine Research Commission have accentuated the concept of being research mobilizers on a global scale."
Marko Neva, Research Officer for AO Spine Europe and Southern Africa, agrees. He finds it is simply amazing how the AO Spine community participated and made these studies possible. "It shows us the true possibilities of a global organization, how to connect, and how hungry we are to share information and develop ourselves."
There are major advantages in being able to evaluate the perspectives of spine surgeons, in learning from each other, and in being able to prepare for the future on a global scale. "We can evaluate what went well and what we could have done better. During the recovery period we can again share information on how to lift restrictions and restart elective surgeries," Neva continues.
The COVID-19 pandemic threatens human life and has a huge impact on our behavior, economies, and international co-operation. It has harmed training of surgeons and put a substantial amount of our research on hold. However, it also pushed telemedicine and telehealth interventions forward by a major leap.
The team is currently addressing the emerging platform of telemedicine and will assess the recovery/back to work phase of this pandemic and its multi-dimensional implications on spine specialists and, in time, the research community.
"It is simply amazing how the AO Spine community participated and made these studies possible. It shows us the true possibilities of a global organization, how to connect, and how hungry we are to share information and develop ourselves.
This study has also taken me into a completely new area in research from my previous experience in the clinical side."
This research was performed in less than three months. Over half a dozen additional studies have emerged from the initial report and have been submitted for publication by the international team and more papers are being published by major spine journals. The World Health Organization (WHO) has requested some of these publications for future planning and decision making.
The initial publication which addresses the impact of COVID-19 pandemic on spine surgeons worldwide was published online as Online First on May 6, 2020 in the Global Spine Journal. In less than a month, the article achieved an Altmetric Attention Score in the top three percent of all 15 million research outputs in the world without being indexed in PubMed or published in any journal.
Samartzis adds that it has become the top article of all similar aged articles, has achieved top three status of all publications since the inception of that journal, and has been addressed by several media platforms, including Spinal News International, Becker's Spine Review, Orthopaedics Today, Orthopaedics This Week, Ortho Spine News, and the Back Letter. The work has been further highlighted in various online webinars and COVID-19 hubs.
The studies focus on profiles and disparities worldwide regarding virtual spine practice and education, implications upon clinical settings, previous experiences with outbreaks and preparedness and response behaviors, surgeon personal health profiles and their effects upon perspectives, health care delivery and clinical decision-making, and future directions.
• The first article published in the Global Spine Journal addressed the multi-dimensional impact of COVID-19 upon healthcare professionals, particularly spine surgeons, worldwide. It also aimed to identify geographical variations and similarities. https://journals.sagepub.com
• An original article published in the European Spine Journal asked if we had learned anything from the past: did experience with previous epidemics help mitigate the impact of COVID‑19 among spine surgeons worldwide? https://www.europeanspinejournal.org
• Another original article published in the Global Spine Journal investigates the preparation, response, and economic impact of COVID-19 on private, public, academic, and privademic spine surgeons. https://journals.sagepub.com
• An original article published in Neurospine determines if personal health of spine surgeons worldwide influences perceptions, healthcare delivery, and decision-making during the COVID-19 pandemic. https://www.e-neurospine.org
• A Research article published in the JOR Spine analyzes the current and future challenges in spine care and education. https://onlinelibrary.wiley.com
The AO Spine study addressed domains of COVID-19 observations, preparedness and response, personal and family life, patient care, education, research, and future perceptions. Responses were collected from over 900 spine surgeons/institutes worldwide, representing over 90 countries. The study was developed by Dino Samartzis (PI, Chairperson, AO Spine International Research Commission), Philip Louie, Mike McCarthy, Howard S. An, Garrett Harada, AO Spine Regional Research Chairs (Jason Cheung, Marko Neva, Marcelo Valacco, and Dan Sciubba), Mohamed El-Sharkawi (Chairperson, AO Spine Middle East and Northern Africa) Norman Chutkan (Chairperson, AO Spine Community Development), and Niccole Germscheid (AO Spine Global Research Manager).
Read also the article on how surgeon health influences healthcare delivery in the age of COVID-19.
