PMC9200426_01
Preoperative condition of the COVID-19 patient with lumbar burst fracture. Chest computed tomography (CT) on axial view (A), lumbar axial CT at the L2 level (B), and T2-weighted magnetic resonance imaging on sagittal view (C).
2432-261X-6-0314-g001.jpg
PMC9200426_01_2432-261X-6-0314-g001.jpg
g001
A 51-year-old woman was diagnosed with moderate COVID-19 pneumonia by polymerase chain reaction testing and chest computed tomography (CT) (Fig. 1A). L2 level (Fig. 1B). Lumbar magnetic resonance imaging revealed that the bone fragments severely compressed the cauda equina at the level of the fracture (Fig. 1C).
(A) Preparation of the operation room. (B) Intraoperative radiological findings. Lateral view of the lumbar spine at prereduction and postreduction.
2432-261X-6-0314-g002.jpg
PMC9200426_01_2432-261X-6-0314-g002.jpg
g002
The emergency surgery was conducted by staff with adequate personal protective equipment, including N95 masks, in an isolated negative-pressure operating room (Fig. 2A). The equipment in the operating room was covered with plastic bags as much as possible (Fig. 2A). Percutaneous pedicle screw fixation was performed at one level above and one level below the fracture level (Fig. 2B).
Postoperative condition of COVID-19 pneumonia with lumbar burst fracture. Lumbar CT at the L2 level (A) and chest CT at postoperative days 6 (B) and 15 (C).
2432-261X-6-0314-g003.jpg
PMC9200426_01_2432-261X-6-0314-g003.jpg
g003
Postoperative CT revealed that the percentage of spinal canal occupied by bone fragments had improved to 25% at the fracture level (Fig. 3A). At postoperative days 6 (Fig. 3B) and 15 (Fig. 3C), COVID-19 pneumonia was confirmed to have improved by chest CT.
Flow-chart (A) and safety checklist (B) for emergency surgery of spinal trauma patients with COVID-19.
2432-261X-6-0314-g004.jpg
PMC9200426_01_2432-261X-6-0314-g004.jpg
g004
Fig. 4 shows the flow-chart and the safety checklist in our institution for emergency surgery of spinal trauma patients with COVID-19.