Emergency surgical management of cervical spine fracture-dislocation with acute paraplegia in COVID-19 (Coronavirus dise
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ORIGINAL ARTICLE
Emergency surgical management of cervical spine fracture‑dislocation with acute paraplegia in COVID‑19 (Coronavirus disease 2019)‑suspected patient: first experience from a German spine centre Mohamed Alhashash1,2 · Walaa Elsebaiy3 · Mohamed Farag1 · Mootaz Shousha1,2 Received: 4 May 2020 / Revised: 15 September 2020 / Accepted: 3 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose We present an organized hospital plan for the management of Coronavirus disease (COVID-19) patients requiring emergency surgical interventions. To introduce a multidisciplinary approach for the management of COVID-19-infected patients and to report the first operated patient in the Corona unit. Methods A detailed presentation of the hospital plan for a separate Corona unit with its intensive care unit and operating rooms. Description of the management of the first spine surgery case treated in this unit. Results The Corona unit showed a practical approach for the management of an emergency cervical spine fracture-dislocation with acute paralysis. The patient is 92-year-old female. The mechanism of injury was a simple fall during the stay in the internal medicine department where the patient was treated in the referring hospital. The patient had no other injuries and was awake and oriented. The patient did not have the clinical symptom of COVID-19, and the test result of COVID-19 done in the referring hospital was not available on admission in our emergency room. Education of the medical staff and organization of the operating theatre facilitated the management of the patient without an increased risk of spreading the infection. Conclusions The current COVID-19 pandemic requires an extra-ordinary organization of the medical and surgical care of the patients. It is possible to manage an infected or a potentially infected patient surgically, but a multidisciplinary plan is necessary to protect other patients and the medical staff. Keywords COVID-19 · Emergency · Cervical fracture · Corona ward · Surgical planning
Introduction Coronavirus disease 2019 In late 2019, a series of severe acute respiratory syndrome (SARS) was reported in China. The causative organism was detected, and the term Coronavirus disease 2019 (COVID19) was introduced [1, 2]. A few weeks later, the number of cases increased dramatically. Cases outside China were * Mohamed Alhashash [email protected] 1
Department of Spine Surgery, Zentralklinik Bad Berka, Robert‑Koch‑Allee 9, 99437 Bad Berka, Germany
2
Department of Orthopedic Surgery, Alexandria University, Alexandria, Egypt
3
Department of Anesthesia and Intensive Care, Alexandria University, Alexandria, Egypt
detected [3]. Confirmation of human-to-human transmission leads to the application of specific measures to reduce the rate of infection and thus to allow medical systems to manage the exponential demand on intensive care beds for such patients. By 11 March 2020, as the number of countries involved reached 114 with more than 118,000 cas
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