Waiting for Spine Surgery in Canada: An Evaluation of Wait Times, Wait Lists, and Surgeries Performed Before and After the Onset of the Covid-19 Pandemic

To examine the impact of the COVID-19 pandemic on wait times for spinal surgery patients in Canada and quantify the number of patients waiting for spinal surgery and spinal surgeries performed. We included consented surgical patients from the 22 orthopaedic or neurological surgical centers participating in the CSORN registry. Study outcomes included wait times from surgical consult to surgery (T2) and from general practitioner referral to surgery (T3), counts of patients on the waitlist and surgeries performed. These outcomes were measured in three-month intervals from December 01, 2017, to February 01, 2022. All cohorts were categorized by severity of their clinical condition as ‘semi-urgent,’ including myelopathy, fracture, infection, tumour, inflammatory spine disorder, spondylolisthesis types 4, 5, and 6, or motor impairments. The remaining patients were classified as ‘elective.’ Quantile regression was used to model the national change in T2 and T3 median days over time. We reported counts for patients waiting for surgery and surgeries performed. The COVID-19 pandemic negatively impacted the national surgical consultation to surgery (T2) and the general practitioner referral to surgery (T3) wait times for elective and semi-urgent surgery patients. The number of patients on the waitlist for both surgical cohorts nearly doubled during the pandemic, and the number of surgeries performed during the pandemic fell. Evidence suggests a negative impact of the COVID-19 pandemic on wait times for elective and semi-urgent spinal surgery subgroups, a trend of increasing waitlists and decreasing spinal surgeries performed. These findings should inform future healthcare policies in the event of another disruptive health emergency and highlight the need to target the backlog of spinal surgeries. Future research should investigate the post-pandemic environment to identify the persistence of surgical delay and its effects on spinal conditions.