Designing a Guideline for Elective and Emergency Spinal Cord Surgeries During the COVID-19 Pandemic

Document Type : Original Article

Authors

1 Assistant Professor of Neurosurgery, Department of Neurosurgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Neurosurgery, Department of Neurosurgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Assistant Professor, Department of Orthopedic, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

4 Associate Professor of Neurosurgery, Department of Neurosurgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Assistant Professor of Spine Surgery, Department of Orthopedics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: There is a need to prepare clinical guidelines for conducting elective or emergency spinal cord surgeries in people who may be carriers of the COVID-19. Therefore, the study aimed to design a guideline for conducting elective spinal cord surgeries during the COVID-19 pandemic.
Methods: The clinical guidelines and systematic reviews providing recommendations for elective and emergency spinal cord surgeries were collected by an initial search. A group of nine experts were designed a domestic preliminary guideline using six available guidelines presented in four studies. Scoring was conducted based on the AGREE (Appraisal of Guidelines Research and Evaluation) tool.
Results: The guideline was prepared in eight subscales, including outpatient visit and counseling, protective measures for health personnel, surgical considerations during the coronavirus pandemic, intraoperative considerations, managing aerosol producing activities, elective and emergency spinal cord surgery, and patient intubation and cardiopulmonary resuscitation. Each of these subscales included several specific recommendations.
Conclusion: It recommended to reduce the capacity of inpatient wards to half during the coronavirus pandemic, give priority only to emergency surgeries, presence of skilled residents (senior year residents), use personal protective equipment, use the least number of people in the operating room, and reduce the length of surgery without compromising its quality.

Keywords


  • Receive Date: 24 September 2021
  • Revise Date: 17 October 2021
  • Accept Date: 16 November 2021
  • First Publish Date: 11 December 2021