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Pulmonary Embolism as a Complication Following Anterior Cervical Discectomy and Fusion in a Patient with a History of COVID-19: A Case Report and Literature Review

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Vol 6 | Issue 2 | July-December 2020 | page: 11-14 | Petros Koutsogiannis, Jordan Fakhoury, Kanwarpaul Grewal, Gus Katsigiorgis Authors: Petros Koutsogiannis [1], Jordan Fakhoury [1], Kanwarpaul Grewal [1], Gus Katsigiorgis [1] [1] Department of Orthopaedic Surgery, Long Island Jewish Hospital- Valley Stream, Northwell Health, New York. Address of Correspondence Dr. Petros Koutsogiannis, Long Island […]

Resource Utilization and Ethics of Urgent Orthopedic Spine Surgery During the COVID-19 Pandemic: A Case Report

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Vol 6 | Issue 2 | July-December 2020 | page: 7-10 | Matthew J. Partan, Peter B. White, Randy M. Cohn, Gus Katsigiorgis, Kanwarpaul Grewal Authors: Matthew J. Partan [1, 2], Peter B. White [1, 2], Randy M. Cohn [1, 3, 4], Gus Katsigiorgis [1, 4], Kanwarpaul Grewal [1, 2, 4] [1] Department of Orthopaedic […]

Pulmonary Embolism as a Complication Following Anterior Cervical Discectomy and Fusion in a Patient with a History of COVID-19: A Case Report and Literature Review

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Resource Utilization and Ethics of Urgent Orthopedic Spine Surgery During the COVID-19 Pandemic: A Case Report

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

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Pulmonary Embolism as a Complication Following Anterior Cervical Discectomy and Fusion in a Patient with a History of COVID-19: A Case Report and Literature Review

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Vol 6 | Issue 2 | July-December 2020 | page: 11-14 | Petros Koutsogiannis, Jordan Fakhoury, Kanwarpaul Grewal, Gus Katsigiorgis

Authors: Petros Koutsogiannis [1], Jordan Fakhoury [1], Kanwarpaul Grewal [1], Gus Katsigiorgis [1]

[1] Department of Orthopaedic Surgery, Long Island Jewish Hospital- Valley Stream, Northwell Health, New York.

Address of Correspondence
Dr. Petros Koutsogiannis,
Long Island Jewish Hospital- Valley Stream, Northwell Health, New York.
E-mail: pkoutsogiann@gmail.com

Abstract

This is a case report of an otherwise healthy 45-year-old male patient with a history of COVID-19, who later underwent an Anterior Cervical Spine Decompression and Fusion of level three to four for progressing neurological symptoms. The patient was readmitted eleven days postoperatively for shortness of breath and found to have a Pulmonary Embolism. The patient was at low risk for postoperative VTE, with no known current significant risk factors. He had a history of COVID-19, along with lab values and imaging that have been shown in other case series to help support the link between covid-19 and hypercoagulable state. We hope to support this hypothesis, and bring light to future larger scale studies, in order to better understand this disease and effectively create a preoperative assessment to identify such patients at risk, along with post-operative protocols for these patients having procedures in the future. To our knowledge, this is the first reported case of confirmed postoperative DVT/PE in an otherwise low-risk patient, who had a history of COVID-19 with full recovery. The rarity of this complication, along with options for how to risk-stratify these patients should be formally addressed, especially in those who require urgent spine surgery. These options are discussed, reviewed, and remarks as to where further attention and research is needed is addressed.

Keywords: Anterior Cervical Discectomy and Fusion; COVID-19; Pulmonary Embolism.

References

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How to Cite this article: Koutsogiannis P, Fakhoury J, Grewal K, Katsigiorgis G | Pulmonary Embolism as a Complication Following Anterior Cervical Discectomy and Fusion in a Patient with a History of COVID-19: A Case Report and Literature Review | Trauma International | July-December 2020; 6(2): 11-14.

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Resource Utilization and Ethics of Urgent Orthopedic Spine Surgery During the COVID-19 Pandemic: A Case Report

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Vol 6 | Issue 2 | July-December 2020 | page: 7-10 | Matthew J. Partan, Peter B. White, Randy M. Cohn, Gus Katsigiorgis, Kanwarpaul Grewal

Authors: Matthew J. Partan [1, 2], Peter B. White [1, 2], Randy M. Cohn [1, 3, 4], Gus Katsigiorgis [1, 4], Kanwarpaul Grewal [1, 2, 4]

[1] Department of Orthopaedic Surgery, Northwell Health Plainview Hospital, Plainview, NY, USA.
[2] Department of Orthopaedic Surgery, Huntington, Northwell Health Huntington Hospital, NY, USA.
[3] Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead, NY, USA. [4] Department of Orthopaedic Surgery, Long Island Jewish Valley Stream Hospital, Valley Stream, NY, USA.

Address of Correspondence

Dr. Matthew J. Partan,
Department of Orthopaedic Surgery, Plainview Hospital, 888 Old Country Road, Plainview, NY, USA.
Email: mpartan@northwell.edu

Abstract

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARs-CoV-2), also known as a coronavirus disease-19 (COVID-19), is a novel respiratory disease that has quickly surmounted to pandemic proportions. The purpose of this case report is to discuss the decision-making process, and resource utilization for spine cases that necessitate urgent surgical intervention in light of the COVID-19 pandemic.
Case Presentation: A twenty-five-year-old Hispanic male presented to an emergency department in Long Island, New York on March 30th, 2020 with incomplete cauda equina with altered bladder function. An MRI revealed a moderately large central disc extrusion of L4/5 with deformation at the ventral thecal sac which resulted in severe spinal stenosis. Given displacement of immediately available resources, the patient required a transfer to an affiliate hospital with readily available operating room staff.
Conclusion: From the time of initial presentation to the emergency room the patient was successfully transferred and brought to the operating room suite within eight hours. The patient underwent an L4/5 decompression and microdiscectomy for a large extruded disk herniation at L4/5 level without complications. With our healthcare system in the epicenter of the COVID-19 pandemic, we are in a unique environment exposed to the harsh characteristics of the surge. In parallel with similarly challenged organizations, our system quickly adapted and adopted various guidelines and committees to organize resource allocation. As demonstrated in this case, the displacement of immediately available resources, such as anesthesia staff, placed strain on the routine workings of surgical coordination. In normal times the decision-making in this case may seem straightforward; however, this case demonstrates the strains that the COVID-19 pandemic placed on our healthcare system especially with regards to surgical acuity, COVID-19 exposure risk and resource allocation.
Keywords: Cauda equine; Spine; Medical ethics; COVID-19.

References

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How to Cite this article: Partan MJ, White PB, Cohn RM, Katsigiorgis G, Grewal K | Resource Utilization and Ethics of Urgent Orthopedic Spine Surgery During the COVID-19 Pandemic: A Case Report | Trauma International | July-December 2020; 6(2): —.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Pulmonary Embolism as a Complication Following Anterior Cervical Discectomy and Fusion in a Patient with a History of COVID-19: A Case Report and Literature Review

Resource Utilization and Ethics of Urgent Orthopedic Spine Surgery During the COVID-19 Pandemic: A Case Report

Pulmonary Embolism as a Complication Following Anterior Cervical Discectomy and Fusion in a Patient with a History of COVID-19: A Case Report and Literature Review

Resource Utilization and Ethics of Urgent Orthopedic Spine Surgery During the COVID-19 Pandemic: A Case Report

Full Sized Blog Element (Big Preview Pic)

Pulmonary Embolism as a Complication Following Anterior Cervical Discectomy and Fusion in a Patient with a History of COVID-19: A Case Report and Literature Review

Authors: Petros Koutsogiannis [1], Jordan Fakhoury [1], Kanwarpaul Grewal [1], Gus Katsigiorgis [1]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

Resource Utilization and Ethics of Urgent Orthopedic Spine Surgery During the COVID-19 Pandemic: A Case Report

Authors: Matthew J. Partan [1, 2], Peter B. White [1, 2], Randy M. Cohn [1, 3, 4], Gus Katsigiorgis [1, 4], Kanwarpaul Grewal [1, 2, 4]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

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