Table 2.
Weekly Adult and Pediatric Neurosurgical Procedures Stratified by Tennessee Gubernatorial Executive Order
| Variable | Before COVID-19 | During COVID-19 | Test Statistic (H) | P Value |
|---|---|---|---|---|
| Study period (weeks) | 7 | 7 | NA | NA |
| Total weekly cases | 75 (72–80) | 45 (43–47) | 38.47 | <0.001∗ |
| Weekly adult cases | 62 (54–70) | 36 (34–39) | 37.08 | <0.001∗ |
| Weekly pediatric cases | 13 (12–14) | 9 (8–10) | 12.33 | 0.004∗ |
| Adult weekly procedures | ||||
| Spine | 20 (18–23) | 8 (6–10) | 37.76 | <0.001∗ |
| Trauma-related spinal procedures | 1 (1–4) | 2 (2–2) | 0.33 | 0.575 |
| Non–trauma-related spinal fusion† | 16 (14–16) | 4 (3–7) | 39.20 | <0.001∗ |
| Non–trauma-related laminectomy, discectomy, foraminotomy, mass resection without fusion† | 3 (3–6) | 1 (0–2) | 11.11 | 0.006∗ |
| Endovascular | 13 (12–18) | 7 (6–10) | 19.03 | <0.001∗ |
| Mechanical thrombectomy for acute ischemic stroke | 3 (1–4) | 3 (2–3) | 0.02 | 0.901 |
| Endovascular treatment of ruptured intracranial aneurysm or vascular malformation | 2 (1–2) | 2 (2–2) | 0.11 | 0.746 |
| Diagnostic angiogram† | 8 (8–10) | 4 (3–5) | 9.37 | 0.010∗ |
| Endovascular treatment of unruptured intracranial aneurysm or vascular malformation† | 3 (2–5) | 1 (1–1) | 19.11 | <0.001∗ |
| Open vascular | 2 (1–4) | 1 (1–2) | 1.22 | 0.291 |
| Craniotomy for spontaneous intracranial hemorrhage evacuation, decompressive craniectomy for stroke, or clipping of ruptured aneurysm | 1 (1–2) | 0 (0–0) | NA | NA |
| Craniotomy for treatment of unruptured aneurysm or vascular malformation† | 1 (0–2) | 1 (1–1) | NA | NA |
| Functional | 9 (8–10) | 6 (6–8) | 1.38 | 0.263 |
| Implantable pulse generator revision or replacement | 3 (3–4) | 5 (4–6) | NA | NA |
| Craniotomy for deep brain stimulation† | 3 (2–3) | 0 (0–0) | NA | NA |
| Other: craniotomy for epilepsy, spinal stimulator insertion, intrathecal baclofen pump insertion or revision, selective dorsal rhizotomy† | 5 (3–6) | 2 (1–2) | NA | NA |
| Cranial tumor | 7 (6–8) | 5 (5–6) | 2.45 | 0.143 |
| Craniotomy for mass resection or brain biopsy | 5 (2–6) | 5 (4–6) | NA | NA |
| Endoscopic endonasal approach surgery for mass resection† | 2 (1–4) | 0 (0–0) | NA | NA |
| Hydrocephalus | 3 (2–4) | 2 (2–2) | 2.10 | 0.173 |
| Cranioplasty† | 2 (2–3) | 0 (0–0) | 35.25 | <0.001∗ |
| Other procedure† | 3 (2–6) | 4 (4–5) | 0.49 | 0.498 |
Data presented as median (interquartile range).
COVID-19, coronavirus disease 2019; NA, not applicable.
∗
Statistically significant.
†
Procedure types with a low clinical likelihood of categorization as high acuity tier 3a or 3b according to American College of Surgeons guide for triage of nonemergent surgical procedures.