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Table 4

Examples of triaging spine surgery in the COVID-19 era [44].

Level Surgical Spine Pathologies Recommendations
Level 1 Cervical or thoracic myelopathy (symptomatic; disc herniations, infections, tumor burden) Proceed with surgical intervention at hospital location.
Level 2 Acute or subacute lumbar disc herniations (up to 6 weeks) with intractable pain Proceed with surgical intervention at ambulatory surgical center (ASC) versus consider at hospital facility if low COVID-19 census.
Level 3 Compression fracture (without neurologic deficits) Defer surgery or reconsider risks versus benefits of continued conservative management.
Consider course of steroid therapy (injection or oral).
Odontoid fractures in elderly will be managed conservatively, with option of treating symptomatic nonunion surgically in future.

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