Cervical Spine Evaluation by Telephone and Video Visit

Abstract

As telecommunication technologies advance, efforts are being made to mitigate direct patient contact in the COVID-19 pandemic due to the risk of contagion. The ability to host telephone and video visits within patient portals within health care institutions will only become increasingly valuable. Neck pain, a common complaint seen in primary care clinics, is well-suited to telemedicine evaluation, as related etiologies are often comparatively straightforward. A good assessment of the cervical spine by telephone or video is possible with the right knowledge and practice. The purpose of this article is to propose questions and maneuvers that can be used to evaluate the cervical spine via telephone or video, as well as likely diagnoses that can be reached through these. Phone and video evaluation of the cervical spine can result in valuable data regarding symmetry, range of motion, functional movement patterns, modified strength testing, and provocative testing. The skill set necessary to do telephone and video visits should be included in the curriculum of physician learners.

Reflections on the future of telemedicine and virtual spinal clinics in the post COVID-19 era

“…Taking into account all the above and accepting a technological standard with sufficient network capabilities offers the best chance of providing a safe and efficient virtual spinal consultation to patients ( Liu et al, 2021 ). Using structured virtual physical examination techniques has also been reported by others ( Pujalte et al, 2021 ) ( Wessell et al, 2021 ) ( Sardar et al, 2021 ), clearly showing this is an area of ongoing refinement and evolution.…”

Interexaminer Reliability and Validity of Quantity of Cervical Mobility during Online Dynamic Inspection

“…It is considered that cervical ROM should be easily estimated via video during a videocall [ 47 ]. However, there is an absence of validity studies for visual estimation of the cervical ROM via video [ 48 ].…”

“…Those considerations must be considered for further studies. Additionally, our study does not provide the values of validity and reliability in a clinical background and focuses only on the analysis of cervical ROM and not on a full telemedicine evaluation for neck pain including also clinical history, inspection, functional movement patterns, strength and provocative testing [ 47 ], so we should be cautious when extrapolating these data clinically.…”

Telehealth in PM&R: Past, present, and future in clinical practice and opportunities for translational research

“…Initial evaluation and triage via telehealth has shown high patient satisfaction and capacity to progress with treatment plans in certain spine disorders. [74][75][76][77] Methods for performing the spine exam have been proposed and discussed [78][79][80][81][82][83][84] with some studies demonstrating high agreement of telehealth compared to in-person examinations, 17,19,[85][86][87] and with more limited studies evaluating VR. 88 Telehealth may be particularly effective for the management of patients with spine disorders who have both advanced imaging and appropriate patient history available, including determining interventional procedures and spine surgery.…”