A New Survey Shows the Challenges Spine Surgeons Are Facing with COVID-19

Spine surgeons around the world are feeling the effects of COVID-19 on their personal and professional lives, including canceled procedures, changes in clinical roles, anxiety, and risk of exposure to the disease due to insufficient personal protective equipment (PPE), according to a study recently published in the Global Spine Journal.

Using a 73-question survey administered between March 27 and April 4, an international team of researchers gathered information from spine surgeons who are members of AO Spine, the largest society of spine surgeons in the world. Questions covered:

  • Personal perspectives, family life, attitudes, and coping strategies
  • Caring for patients
  • Implications of government and leadership
  • Financial impact of COVID-19
  • Research
  • Education and training
  • Future challenges and impact


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The researchers evaluated survey responses from 902 spine surgeons. With some geographic variations, the majority of the surgeons reported that 75% of their surgical cases were canceled each week since the start of the pandemic. Surgeons also reported experiencing elevated anxiety and uncertainty, and nearly 95% expressed a need for formal international guidelines about how to manage patients with COVID-19.

“Some institutes have some form of guidelines here and there, but standardized formal [guidelines] don’t exist in the community and are needed,” said Dino Samartzis, DSc, Associate Professor in the Department of Orthopaedic Surgery at Rush Medical College and the primary study investigator.

“This study shows that we need to prepare for other disasters moving ahead or risk history repeating itself.”

Among the study findings:

  • 23% of survey respondents reported working outside their normal scope of practice during the pandemic
  • 81% said they were no longer performing elective surgery, but 87% reported that they were performing emergency/essential surgery.
  • 83% reported that they had access to COVID-19 testing, but only 7% said they had been tested; 16% tested positive for COVID-19
  • 50% said they lacked adequate PPE
  • 37% reported having at least 1 chronic disease, such as high blood pressure, placing them at a higher risk from COVID-19

“The study further brings to light that regional variations also exist. This is very important for institutes, academia, and industry to take stock in their current and future planning, decision-making, and more personalized approaches to help facilitate and provide the necessary technology for the spine specialists to optimize their patient care and outcomes,” Dr. Samartzis said.

Howard S. An, MD, the Morton International Endowed Chair Professor and director of the Spine Surgery Fellowship program in the Department of Orthopaedic Surgery at Rush Medical College and a co-investigator of this study, noted, “During this pandemic, the spine specialist has been a forgotten soldier. The impact this has had on their practice and patients is far-reaching since a surgical practice, in particular, supports and works with so many health specialists and support staff, and manages patients in immense pain and disability looking for solutions.

“If their practice is affected, everyone else will be affected. Society as a whole will be, to some degree, affected even further.”


Louie PK, Harada GK, McCarthy MH, et al. The impact of COVID-19 pandemic on spine surgeons worldwide. Global Spine Journal. 6 May 2020. Published online ahead of print.


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