The Impact of COVID-19 and Lockdown on Spinal Services at a National Level: Lessons Learned and Areas of Service Improvement for Future Health Care Delivery.

The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on the provision of health care worldwide. The delivery of national spinal service for emergent surgery, elective surgery, and outpatient assessment has been incredibly challenging. A variety of innovative measures were undertaken to facilitate the safe provision of acute service and are outlined in this review, along with a number of key learning points which will improve the quality of health care delivered over the coming years.

The diagnostic and prognostic value of artificial intelligence and artificial neural networks in spinal surgery : a narrative review.

In recent years, machine learning (ML) and artificial neural networks (ANNs), a particular subset of ML, have been adopted by various areas of healthcare. A number of diagnostic and prognostic algorithms have been designed and implemented across a range of orthopaedic sub-specialties to date, with many positive results. However, the methodology of many of these studies is flawed, and few compare the use of ML with the current approach in clinical practice.

The impact of the SARS-CoV-2 pandemic on referral characteristics in a national tertiary spinal injuries unit.

Background: The SARS-CoV-2 pandemic has had profound implications on healthcare institutions.

Aims: This study aims to assess and compare referral patterns during COVID-19 to corresponding dates for the preceding 3 years (2017-2019), in order to preemptively coordinate the logistics of the surgical unit for similar future experiences.

Methods: Retrospective review for our institution, a national tertiary referral centre for spine pathology.

Paediatric major trauma in the setting of the Irish trauma network.

Background: The construction of a new tertiary children's hospital and reconfiguration of its two satellite centres will become the Irish epicentre for all paediatric care including paediatric trauma. Ireland is also currently establishing a national trauma network although further planning of how to manage paediatric trauma in the context of this system is required. This research defines the unknown epidemiology of paediatric major trauma in Ireland to assist strategic planning of a future paediatric major trauma network.

Instant messaging apps and data protection: combining to improve hip fracture care?

Introduction: The General Data Protection Regulation (GDPR) continues to have implications for how healthcare information is managed and shared. This presents challenges as telemedicine plays a more central role in service healthcare service provision, particularly since the beginning of 2020. We aim to measure how improved communication through a GDPR-compliant messaging app can influence time-dependent key performance indicators for hip fracture management in a tertiary-referral trauma hospital.

Locked pubis symphysis in a skeletally immature patient, a case report.

Background: Locked symphysis pubis is an exceedingly rare pelvic injury especially in the paediatric population. This study is the first to describe this fracture in a skeletally immature patient.

Case Report: We report the case of a fifteen year old boy who presented to the Emergency Department (ED) after being involved in a farming injury with a left lateral compression pelvic trauma.

Crisis change management during COVID-19 in the elective orthopaedic hospital: Easing the trauma burden of acute hospitals.

Introduction: With the emergence of the 2019 novel coronavirus and its resulting pandemic status in March 2020 all routine elective orthopaedic surgery was cancelled in our institution. The developing picture in Italy, of acute hospitals becoming overwhelmed with treating patients suffering with severe and life-threatening symptoms from the disease, prompted the orthopaedic surgeons to formulate a plan to transfer trauma patients requiring surgery to the elective hospital to unburden the acute hospital system.

Methods: Under the threat of this pandemic; protocols and algorithms were established for referral, acceptance and care of trauma patients from acute hospitals in the region.

Epidemiology of non-traumatic spinal cord injury in Ireland - a prospective population-based study.

To carry out a study of non-traumatic spinal cord injury (NTSCI) epidemiology in Ireland Prospective study of all new incident cases of NTSCI during 2017 Republic of Ireland: All persons with a newly acquired NTSCI: None: Crude and age/sex specific incidences; ISCoS core dataset and non-traumatic dataset; population denominator was 2016 national census figures, adjusted to 2017. Overall crude incidence of NTSCI in the Republic of Ireland in 2017 was 26.9 per million per year.

Minimally invasive fasciotomy using a lighted retractor in the treatment of chronic exertional compartment syndrome.

Chronic exertional compartment syndrome can be a debilitating cause of lower leg pain that typically affects young, healthy people during a variety of aerobic activities. Conservative management has produced a poor success rate and numerous techniques for surgical decompression have been described. Many of these, however, involve blind fascial dissection which increases the risk of direct nerve injury or insufficient fascial release.

Prospective epidemiological update on traumatic spinal cord injury in Ireland.

Study Design: Prospective population-based epidemiological study on traumatic spinal cord injury in Ireland.

Objectives: To provide updated data for the global TSCI repository.

Setting: Republic of Ireland.

Metastasis Affecting Craniocervical Junction: Current Concepts and an Update on Surgical Management.

Study Design: Literature review.

Objectives: Metastatic disease affecting the craniovertebral junction (CVJ) only accounts for 0.5% of all spine metastases.

Epidemiology of Traumatic Spinal Cord Injury in Ireland, 2010-2015.

Background: The International Spinal Cord Society and World Health Organisation recommend the collection of epidemiological data on traumatic spinal cord injury (TSCI). A 1-year prospective study is ongoing in Ireland. While the results of this study are awaited, it was concluded from a feasibility exercise that a complete retrospective dataset, 2010-2015, could be obtained and would be useful for service planning.

The 100 most cited papers in spinal deformity surgery: a bibliometric analysis.

Spinal deformity is a condition that has been recognized for many millennia. There have been major advances in the treatment of spinal deformity in recent years and studies outlining new ideas can inspire others to further advance the speciality. The number of citations a paper receives may indicate the influence of that paper.

The Oswestry Spinal Risk Index (OSRI): an external validation study.

Purpose: The Oswestry Spinal Risk Index (OSRI) was recently reported as an adjunct in the management of metastatic spinal disease. Based on the tumour type and a general condition score, survivorship is predicted. We aimed to externally validate this new score.

Road collisions as a cause of traumatic spinal cord injury in ireland, 2001-2010.

Background: Road collisions remain the leading cause of traumatic spinal cord injury (TSCI) in the world. Half of all TSCIs in Ireland in 2000 were caused by road collisions. Since then, there has been a downward trend in road fatalities coincident with implemented road safety strategies.

Cauda equina syndrome: assessing the readability and quality of patient information on the Internet.

Study Design: A readability and quality control Internet-based study using recognized quality scoring systems.

Objective: To assess the readability and quality of Internet information relating to cauda equina syndrome accessed through common search engines.

Summary Of Background Data: Access to health-related Internet information has increased dramatically during the past decade.

Cervical epidural abscess following an Escherichia coli urinary tract infection.

A previously healthy 64-year-old man developed an Escherichia coli spinal epidural abscess (SEA) isolated to the cervical vertebrae posturinary tract infection 9 days previously. He subsequently underwent emergent surgical decompression followed by a prolonged course of intravenous antibiotics. He is symptom free at 1-year follow-up.

Management of simultaneous bilateral neck of femur fractures in an elderly patient.

Simultaneous bilateral neck of femur fracture is rare. There have been few reports of such a condition in the literature. This uncommon pattern of injury has been associated with high-energy trauma, underlying bone disease, and seizure disorders.

Acute traumatic spinal injury following bicycle accidents: a report of three cases.

Although the vast majority of injuries suffered while cycling are minor, acute spinal injuries have been reported. We describe three cases of acute spinal injury occurring while cycling. All three patients reported being thrown over the handlebars, while travelling downhill at speed.

Intramedullary versus extramedullary alignment of the tibial component in the Triathlon knee.

Background: Long term survivorship in total knee arthroplasty is significantly dependant on prosthesis alignment. Our aim was determine which alignment guide was more accurate in positioning of the tibial component in total knee arthroplasty. We also aimed to assess whether there was any difference in short term patient outcome.

Diagnostic gait pattern of a patient with longstanding left femoral nerve palsy: a case report.

The gait pattern of a 35-year-old man with longstanding, left femoral nerve palsy was assessed using 3-dimensional kinematic and kinetic analysis. Stability of his left knee in stance was achieved by manipulating the external moments of the limb so that the ground reaction force passes in front of the knee joint. This compensatory mechanism of locking the knee in extension is reliant on the posterior capsular structures.

Segmental fracture of the lumbar spine.

Study Design: A case report is presented.

Objective: To describe a rare, previously undescribed pattern of spinal injury.

Summary Of Background Data: This seems to be a unique injury with no previously described injuries matching the fracture pattern observed.

Risk analysis of blood transfusion requirements in emergency and elective spinal surgery.

Spinal surgery has long been considered to have an elevated risk of perioperative blood loss with significant associated blood transfusion requirements. However, a great variability exists in the blood loss and transfusion requirements of differing patients and differing procedures in the area of spinal surgery. We performed a retrospective study of all patients undergoing spinal surgery who required a transfusion≥1 U of red blood cells (RBC) at the National Spinal Injuries Unit (NSIU) at the Mater Misericordiae University Hospital over a 10-year period.

Saturday night palsy or Sunday morning hangover? A case report of alcohol-induced Crush Syndrome.

Saturday night palsy is a colloquial term given to brachial plexus injuries of the arm resulting from stretching or direct pressure against a firm object, often after alcohol or drug consumption. In most circumstances, this condition gives rise to a temporary plexopathy, which generally resolves. However, if the compression is severe and prolonged, a more grave form of this condition known as 'Crush Syndrome' may occur.