COVID-19 and the rise of virtual medicine in spine surgery: a worldwide study

Abstract

Purpose The COVID-19 pandemic forced many surgeons to adopt “virtual medicine” practices, defined as telehealth services for patient care and online platforms for continuing medical education. The purpose of this study was to assess spine surgeon reliance on virtual medicine during the pandemic and to discuss the future of virtual medicine in spine surgery. Methods A comprehensive survey addressing demographic data and virtual medicine practices was distributed to spine surgeons worldwide between March 27, 2020, and April 4, 2020. Results 902 spine surgeons representing seven global regions responded. 35.6% of surgeons were identified as “high telehealth users,” conducting more than half of clinic visits virtually. Predictors of high telehealth utilization included working in an academic practice (OR = 1.68, p = 0.0015) and practicing in Europe/North America (OR 3.42, p < 0.0001). 80.1% of all surgeons were interested in online education. Dedicating more than 25% of one’s practice to teaching (OR = 1.89, p = 0.037) predicted increased interest in online education. 26.2% of respondents were identified as “virtual medicine surgeons,” defined as surgeons with both high telehealth usage and increased interest in online education. Living in Europe/North America and practicing in an academic practice increased odds of being a virtual medicine surgeon by 2.28 (p = 0.002) and 1.15 (p = 0.0082), respectively. 93.8% of surgeons reported interest in a centralized platform facilitating surgeon-to-surgeon communication. Conclusion COVID-19 has changed spine surgery by triggering rapid adoption of virtual medicine practices. The demonstrated global interest in virtual medicine suggests that it may become part of the “new normal” for surgeons in the post-pandemic era.

XR (Extended Reality: Virtual Reality, Augmented Reality, Mixed Reality) Technology in Spine Medicine: Status Quo and Quo Vadis

“…The digital transformation wave has also arrived in spine medicine [14,15], largely due to the development of the four digital platforms for handling high-performance big data: collection, communication, editing, and viewing. For example, especially in telemedicine, the combination of high-performance information (i.e., high-resolution CT, wearable sensors, 360 • operative camera), high-performance information communication technologies, high-performance edited images (i.e., 3D medical images or holograms) created using artificial intelligence (AI), and high-performance viewing using a head-mounted display (HMD) has been useful for diagnostics and treatment decisions [16,17]. Thus, advancement in digital transformation combined with the development of intelligence technology for handling high-performance information collection, communication, editing, and viewing has further expanded the application of XR technology in spine medicine.…”

“…Thus, the use of technology to maintain medical treatment and education has become more rapid and innovative than ever before. As a result, many healthcare organizations have been increasingly interested in XR technology: patient care and management, the education of residents and medical students (i.e., online lectures, remote access to teaching ward rounds by XR technology [36], preoperative planning and simulation, and remote rehabilitation (telerehabilitation) [17,36,37].…”

“…The limitations of telemedicine in performing a physical examination or collecting proper manual neurological findings in the field of spine medicine have been the biggest obstacle to adoption by spinal surgeons [85]. Guidelines have been developed for the implementation of virtual physical examinations, including specific testing methods for spine surgeons to assess the physical function, motor strength, and sensation [17,[86][87][88]; however, these are still insufficient. In the future, research is needed to standardize remote control and improve the accuracy of remote diagnoses.…”

Telemedicine use by neurosurgeons due to the COVID-19 related lockdown

“…As the use of telemedicine has increased massively during the COVID-19 pandemic, so has the research on the use of telemedicine ( Tandon et al, 2021 ; Shafi et al, 2021 ; Swiatek et al, 2021 ; Ryu et al, 2021 ; Zengin et al, 2021 ; Lovecchio et al, 2020 ; Mohanty et al, 2020 ; Riew et al, 2021 ) . Table 5 gives an overview of eight published survey results on the use of telemedicine during the COVID-19 pandemic among neurological and spine surgeons.…”

COVID-19 and its Impact on Back Pain

“…20 Over half of spine surgeons worldwide reported using telehealth to conduct a significant (>25%) number of patients visits. [21][22][23][24][25][26][27] This leads the potential to exacerbate healthcare disparities within underserved areas without internet access. [21][22][23][24][25][26][27] Should virtual health persist beyond the pandemic, infrastructure should be implemented into underserved areas across the developed and undeveloped world to increase access to experienced clinicians.…”