Objective To evaluate the trends in school-based scoliosis screening programs, with a focus on the impact of coronavirus disease 2019 (COVID-19) pandemic, including its effects on referral numbers and radiological profiles of patients with adolescent idiopathic scoliosis (AIS).
Methods A total of 298,666 volunteer individuals participated in the school-based scoliosis screening program, classified into 2 groups; prepandemic group (between 2017 and 2019, n=201,160) and postpandemic group (between 2021 and 2023, n=97,506). The data included referral volumes, the prevalence rate of AIS, and trends in both referral patterns and the characteristics of the screened population.
Results The prevalence rate of AIS among the screened population was significantly higher in the postpandemic group (49.35%; 95% confidence interval [CI], 48.12–50.59) compared to the prepandemic group (41.47%; 95% CI, 40.71–42.24) (p<0.001). The postpandemic group also exhibited significantly younger age (p<0.001), lower body weight (p<0.001), earlier onset of menarche (p<0.001), and a larger Cobb angle in females (p<0.001) compared to the prepandemic group. Additionally, the proportion of individuals not recognizing their AIS was significantly higher in the postpandemic group (99.74%) compared to the prepandemic group (88.87%) (p<0.001).
Conclusion Lockdown for preventing COVID-19 pandemic negatively affected the school-based scoliosis screening program. While the overall prevalence of AIS remained stable, the detection rate in the screened population increased, accompanied by younger ages, earlier menarche, and higher Cobb angles (in females) following the COVID-19 pandemic.
Objective The present study is to analyze the effects of the coronavirus disease 2019 (COVID 2019) outbreak and the subsequent lockdown on the outcomes of spinal metastasis patients.
Methods The study was a retrospective analysis of data from a prospective cohort study. All patients underwent surgical intervention for spinal metastases between January 2019 and December 2021 and had at least 3 months of postoperative follow-up. The primary outcome was overall mortality during the 4 different stages (pre-COVID-19 era, COVID-19 pandemic except in Taiwan, national lockdown, lifting of the lockdown). The secondary outcomes were the oncological severity scores, medical/surgical accessibility, and patient functional outcome during the 4 periods as well as survival/mortality.
Results A total of 233 patients were included. The overall mortality rate was 41.20%. During the Taiwan lockdown, more patients received palliative surgery than other surgical methods, and no total en bloc spondylectomy was performed. The time from surgeon visit to operation was approximately doubled after the COVID-19 outbreak in Taiwan (75.97, 86.63, 168.79, and 166.91 hours in the 4 periods, respectively). The estimated survival probability was highest after the national lockdown was lifted and lowest during the lockdown. In the multivariate analysis, increased risk of mortality was observed with delay of surgery, with emergency surgery having a higher risk with delays above 33 hours, urgent surgery (below 59 and above 111 hours), and elective surgery (above 332 hours).
Conclusion The COVID-19 pandemic and related policies have altered daily clinical practice and negatively impacted the survival of patients with spinal metastases.
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Objective To assess the effect of transitioning to remote working during the coronavirus disease 2019 pandemic in a population of adults affected by chronic low back pain (cLBP).
Methods An online questionnaire was sent by email to teleworkers affected by cLBP. Demographic data, remote working features and tasks, and LBP burden were analyzed. The psychological burden of remote working was evaluated with the World Health Organization Five Well-Being Index and the Patient Health Questionnaire-2. LBP severity was evaluated using a visual analogue scale. LBP-related disability was assessed using the Oswestry Disability Index. The effect of LBP on working capacity was examined with the Occupational Role Questionnaire. Independent risk factors related to LBP worsening were identified using a multivariate logistic regression model.
Results During remote working, LBP severity was significantly higher compared to previous in-person working (p < 0.0001), as well as average weekly work hours (p < 0.001). Furthermore, the risk of LBP worsening was associated with higher depression scores (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.00–1.91; p = 0.048), increased stress levels (OR: 3.00, 95% CI: 1.04–8.65; p = 0.042), and being divorced (OR: 4.28, 95% CI: 1.27–14.47; p = 0.019). Conversely, living with others (OR: 0.24, 95% CI: 0.07–0.81; p = 0.021), and reporting unchanged stress levels (OR: 0.22, 95% CI: 0.08–0.65; p = 0.006) were associated with a lower risk of LBP worsening.
Conclusion Our findings highlight key factors to consider for improving remote workers’ physical and mental wellbeing and decrease their LBP burden.
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Objective To determine if personal health of spine surgeons worldwide influences perceptions, healthcare delivery, and decision-making during the coronavirus disease 2019 (COVID-19) pandemic.
Methods A cross-sectional study was performed by distributing a multidimensional survey to spine surgeons worldwide. Questions addressed demographics, impacts and perceptions of COVID-19, and the presence of surgeon comorbidities, which included cancer, cardiac disease, diabetes, obesity, hypertension, respiratory illness, renal disease, and current tobacco use. Multivariate analysis was performed to identify specific comorbidities that influenced various impact measures.
Results Across 7 global regions, 36.8% out of 902 respondents reported a comorbidity, of which hypertension (21.9%) and obesity (15.6%) were the most common. Multivariate analysis noted tobacco users were more likely to continue performing elective surgery during the pandemic (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.46–4.72; p = 0.001) and were less likely to utilize telecommunication (OR, 0.51; 95% CI, 0.31–0.86; p = 0.011), whereas those with hypertension were less likely to warn their patients should the surgeon become infected with COVID-19 (OR, 0.57; 95% CI, 0.37–0.91; p = 0.017). Clinicians with multiple comorbidities were more likely to cite personal health as a current stressor (OR, 1.32; 95% CI, 1.07–1.63; p = 0.009) and perceived their hospital’s management unfavorably (OR, 0.74; 95% CI, 0.60–0.91; p = 0.005).
Conclusion This is the first study to have mapped global variations of personal health of spine surgeons, key in the development for future wellness and patient management initiatives. This study underscored that spine surgeons worldwide are not immune to comorbidities, and their personal health influences various perceptions, healthcare delivery, and decision-making during the COVID-19 pandemic.
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