All patients will be screened for symptoms prior to presenting to the hospital. Surgery will be deferred if the patient is symptomatic and/or exposed to infection in the previous 14 days. Patients remaining asymptomatic, will undergo nucleic acid amplification testing (including PCR tests). If the test is negative and they remain in isolation prior to their date of surgery, elective surgery can be performed.
Screening by history:
Screening for SARS-CoV-2 via careful symptom history is important. Population screening studies have demonstrated that 10-30% of patients could be asymptomatic at the time of screening. Screening should include an assessment of:
• Exposure to someone diagnosed with COVID-19 in the past 14 days; and
• Unexplained fever, cough, shortness of breath, chills, muscle pain, headache, sore throat, and/or new loss of taste or smell within the prior two weeks.
COVID19 Antigen testing
The reported antigen sensitivity of SARS-CoV-2 testing is approximately 70% to 90%, meaning that up to 30% of infected patients may be reported as free of the virus. Viral transmission may occur up to three days before patients become symptomatic. Viral shedding is generally undetectable by 21 days following infection; however, it may occur beyond that in severe infections. For pre-operative screening purposes, only asymptomatic patients will be offered antigen testing and/or 21 days after their initial symptoms AND they become symptom free at least last 7 days.
Antibody testing does not have a role in perioperative screening and risk stratification. Antibodies develop in the second week of symptoms and not all patients who are infected with SARS-CoV-2 develop detectable antibodies. Additionally, antibody tests have the potential of cross-reaction with other coronaviruses, resulting in false-positive results. As a result, antibody testing should not be performed during routine preoperative screening.
Is it safe to have spinal surgery during Covid-19 outbreak ?
As long as you have no underlying medical risk factors and do not have Covid-19 infection and all safety precautions are in place then there is no increased risk of spinal surgery.
How do I know if I have Covid-19 before spinal surgery?
Most patients will show symptoms although some will have no symptoms. Swab tests from the nose and throat and antibody blood tests can identify whether you have or previously had coronavirus infection. Testing should be done before surgery.
Is there a higher risk of contracting Covid-19 after spinal surgery ?
The surgery itself does not increase the risk of catching an infection. However, the infection may be more serious if you do catch it. You should take extra precautions such as self isolation for a period of 2 weeks after surgery.