Spine Surgery and COVID-19: The Influence of Practice Type on Preparedness, Response, and Economic Impact

Joseph A. Weiner, Peter R. Swiatek, Daniel J. Johnson, Philip K. Louie, Garrett K. Harada, Michael H. McCarthy, Niccole Germscheid, Jason P.Y. Cheung, Marko H. Neva, Mohammad El-Sharkawi, Marcelo Valacco, Daniel M. Sciubba, Norman B. Chutkan, Howard S. An, Dino Samartzis

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Study Design: Cross-sectional observational cohort study. Objective: To investigate preparation, response, and economic impact of COVID-19 on private, public, academic, and privademic spine surgeons. Methods: AO Spine COVID-19 and Spine Surgeon Global Impact Survey includes domains on surgeon demographics, location of practice, type of practice, COVID-19 perceptions, institutional preparedness and response, personal and practice impact, and future perceptions. The survey was distributed by AO Spine via email to members (n = 3805). Univariate and multivariate analyses were performed to identify differences between practice settings. Results: A total of 902 surgeons completed the survey. In all, 45.4% of respondents worked in an academic setting, 22.9% in privademics, 16.1% in private practice, and 15.6% in public hospitals. Academic practice setting was independently associated with performing elective and emergent spine surgeries at the time of survey distribution. A majority of surgeons reported a >75% decrease in case volume. Private practice and privademic surgeons reported losing income at a higher rate compared with academic or public surgeons. Practice setting was associated with personal protective equipment availability and economic issues as a source of stress. Conclusions: The current study indicates that practice setting affected both preparedness and response to COVID-19. Surgeons in private and privademic practices reported increased worry about the economic implications of the current crisis compared with surgeons in academic and public hospitals. COVID-19 decreased overall clinical productivity, revenue, and income. Government response to the current pandemic and preparation for future pandemics needs to be adaptable to surgeons in all practice settings.

Original languageEnglish (US)
Pages (from-to)249-262
Number of pages14
JournalGlobal Spine Journal
Issue number2
StatePublished - Mar 2022


  • COVID-19
  • coronavirus
  • global
  • impact
  • private practice
  • spine; surgeons

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine


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