Medical Student University of Alabama at Birmingham
Introduction: The COVID-19 pandemic imposed exceptional challenges on healthcare systems, with lasting impacts on surgical efficiency. Spine surgeries, requiring meticulous planning, are particularly affected. The onset of "The Great Resignation" in April 2020 led to workforce shortages and increased turnover, further disrupting operating room efficiency. This study aims to quantify the pandemic's sustained impact on spine surgery efficiency at a high-volume academic center.
Methods: This retrospective study analyzed spine surgeries at the University of Alabama at Birmingham from October 2015 to November 2022. Procedures were categorized as pre- or post-pandemic, with April 1, 2020, marking the onset of “The Great Resignation.” Time-related variables were compared using the Mann-Whitney U test, with False Discovery Rate (FDR) correction applied.
Results: A total of 5,934 spine surgeries were included, with 3,629 (61.2%) pre-pandemic and 2,305 (38.8%) post-pandemic. The most common procedures were lumbar fusion (20.6%) and cervical fusion (16.4%). Patient demographics remained consistent across both periods, with a median age of 63 years (IQR=20), BMI of 29.17 (IQR=8.3), and ASA score of 3 (IQR=0). Post-pandemic, significant increases in operative times were noted for nearly all spine procedures, most notably lumbar fusion (+57 minutes, p < 0.0001), cervical fusion (+43 minutes, p < 0.0001), lumbar decompression with Metrex (+31 minutes, p < 0.0001), and thoracic fusion (+36 minutes, p = 0.001). Procedure times also increased significantly, with lumbar fusion rising by 46 minutes (p < 0.0001) and cervical fusion by 34 minutes (p < 0.0001).
Conclusion : The COVID-19 pandemic led to substantial and lasting delays in spine surgery efficiency, particularly for lumbar and cervical fusions. These findings highlight the need for further research into the causes of these delays, including the potential role of increased staff turnover. Addressing these challenges will require innovative solutions, potentially including technology-driven interventions, to restore efficiency and prepare surgical teams for future disruptions.