Table 1.

Guide to Outline a Triaging System of Spine-Specific Surgical Care.^a

Category	Clinical Considerations	Recommendation
Emergent	• Progressive or severe neurologic deficit due to neurologic compression from any cause • Spinal instability at risk of causing neurologic injury from any cause • Epidural abscess requiring surgical decompression • Postoperative wound infection	Do not delay
Urgent	• Myelopathy due to spinal stenosis, with recent progression • Spinal infection (eg, discitis, osteomyelitis, epidural abscess) that fails to respond to medical management • Persistent significant neurologic deficit due to neurologic compression with or without deformity (distinguished from “severe neurologic deficit” that is listed under emergent) • Spinal conditions causing intractable pain that result in emergency room presentation, severe functional limitations and/or excessive opioid use despite nonprocedural attempts at management (eg, painful disc herniation, painful fracture, progressive fracture related deformity).	Proceed if local health care guidelines permit such cases to occur and there are adequate health care resources available to safely perform the procedure
Elective	• Spinal conditions where pain and dysfunction can be reasonably managed without procedural intervention during the pandemic (eg, chronic conditions, degenerative spinal disorders such as degenerative disc disease, some disc herniations, spinal stenosis, or spondylolisthesis without significant neurologic deficit) • Scoliosis and/or kyphosis correction • Symptomatic hardware or pseudoarthosis	Consider postponing the procedure/treatment

^a The table is adapted from The North American Spine Society (NASS).²⁵