After the Centers of Medicare and Medicaid Services recommended delaying elective surgeries in the United States due to the SARS-CoV-2 pandemic, operative volumes across the United States decreased. There is minimal information on the pandemics national impact on pediatric neurosurgical operative volumes.Methods: The national database, TriNetX, was used to measure the average number of pediatric neurosurgeries performed during each month and season of the pandemic from March 2020 to May 2021. Current Procedural Terminology (CPT) and International Classification of Diseases-10 (ICD-10) codes were used to identify pediatric SPINE, craniotomy, shunt, epilepsy, and trauma surgeries on July 27, 2021. A students t-test was used to compare the monthly mean operative volume per reporting health care organization with a pooled corresponding average between March 2018 and February 2019 to represent the pre-pandemic period.
There was an inverse relationship between pediatric neurosurgical operative volumes and the incidence of COVID-19 cases. From March 2020 to May 2021, there was a significant decrease in the number of shunt (-11.7% mean change, p = 0.006), neurosurgical trauma (-13.8%, p < 0.001), and epilepsy (-16.6%, p < 0.001) surgeries compared to pre-pandemic years. A seasonal analysis revealed a broad decrease in pediatric neurosurgery in Spring 2020 and Winter 2020 followed by a rebound increase in operative volumes in Summer 2020 and Spring 2021.
This is the first study to investigate national trends in pediatric neurosurgery procedures in the United States during the COVID-19 pandemic. As a whole, pediatric neurosurgery procedure volumes decreased significantly during peak incidences of COVID-19 cases and subsequently increased above pre-pandemic levels as cases tapered. As the delta variant continues to spread across the United States, pediatric neurosurgeons need to remain cognizant for potential changes in patient volumes as COVID-19 cases continue to fluctuate.