Systematic review of telemedicine in spine surgery

Kolcun, John Paul G.; Ryu, Won Hyung A.; Traynelis, Vincent C.

doi:10.3171/2020.6.spine20863

Cited by 19 publications

(25 citation statements)

References 31 publications

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“…Telemedicine usage among spine surgeons has rapidly risen in response to the novel coronavirus (COVID-19) pandemic and social distancing directives [1][2][3][4][5][6]. In a global survey investigating the impact of COVID-19 on spine surgeons, Louie et al [1] found that 35.6% of respondents were performing the majority of appointments via telemedicine by the end of the first quarter of 2020.…”

Section: Introductionmentioning

confidence: 99%

Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

et al. 2021

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Introduction While telemedicine usage has increased due to the COVID-19 pandemic, there remains little consensus about how spine surgeons perceive virtual care. The purpose of this study was to explore international perspectives of spine providers on the challenges and benefits of telemedicine. Methods Responses from 485 members of AO Spine were analyzed, covering provider perceptions of the challenges and benefits of telemedicine. All questions were optional, and blank responses were excluded from analysis. Results The leading challenges reported by surgeons were decreased ability to perform physical examinations (38.6%), possible increased medicolegal exposure (19.3%), and lack of reimbursement parity compared to traditional visits (15.5%). Fewer than 9.0% of respondents experienced technological issues. On average, respondents agreed that telemedicine increases access to care for rural/long-distance patients, provides societal cost savings, and increases patient convenience. Responses were mixed about whether telemedicine leads to greater patient satisfaction. North Americans experienced the most challenges, but also thought telemedicine carried the most benefits, whereas Africans reported the fewest challenges and benefits. Age did not affect responses. Conclusion Spine surgeons are supportive of the benefits of telemedicine, and only a small minority experienced technical issues. The decreased ability to perform the physical examination was the top challenge and remains a major obstacle to virtual care for spine surgeons around the world, although interestingly, 61.4% of providers did not acknowledge this to be a major challenge. Significant groundwork in optimizing remote physical examination maneuvers and achieving legal and reimbursement clarity is necessary for widespread implementation.

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Section: Introductionmentioning

confidence: 99%

Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

et al. 2021

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“…In general, RCTs in eHealth are few despite occurrence of the COVID-19 pandemic situation, which has demonstrated a need for more evidence-based knowledge about the use of digital health technology in evaluating treatment effect, safety, and other aspects of patient management [34][35][36][37]. Patient education programs [38,39]; evaluation of psychological distress using teletechnology in diabetes [40]; use of mobile in suboptimal health [41], surgery care, and follow-up [42][43][44]; aphasia [44]; HIV consultations [38]; cancer symptom monitoring [45]; motor and cognitive function in stroke [46]; and COVID-19 follow-up [47] are areas where RCTs are used. Moreover, this study agrees with previous telemedicine RCTs in the same area reporting positive outcomes in treating diabetic foot ulcer [48] and in a follow-up study of orthopedic patients [49].…”

Section: Comparison With Prior Workmentioning

confidence: 99%

One-Year Remission Rate of Chronic Headache Comparing Video and Face-to-Face Consultations by Neurologist: Randomized Controlled Trial

Bekkelund¹,

Müller²

2021

J Med Internet Res

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Background Chronic headache causing severe headache-related disability for those affected by the disease is under- or misdiagnosed in many cases and therefore requires easy access to a specialist for optimal health care management. Objective The goal of the research is to determine whether video consultations are noninferior to face-to-face consultations in treating chronic headache patients referred to a specialist in Northern Norway. Methods Patients included in the study were recruited from general practice referrals to a specialist at a neurological department in Northern Norway (Tromsø) and diagnosed according to the International Headache Society classification system. In a randomized controlled design, the 1-year remission rate of chronic headache (change from ≥15 to <15 headache days per month during the last 3 months), patient satisfaction with a specialist consultation, and need for follow-up consultations by general practitioners were compared between groups consulted by video and face-to-face in a post hoc analysis. Data were collected by interview (baseline) and questionnaire (follow-up). Results From a baseline cohort of 402 headache patients consecutively referred from general practice to a specialist over 2.5 years, 58.0% (233/402) were classified as chronic headache and included in this study. Response rates were 71.7% (86/120) in the video group and 67.3% (76/113) in the face-to-face group. One-year remission from chronic headache was achieved in 43.0% (37/86) in the video group and 39.5% (30/76) in the face-to-face group (P=.38). Patient satisfaction with consultations were 86.5% (32/37; video) and 93.3% (28/30; face-to-face; P=.25). A total of 30% (11/37) in the video group and 53% (16/30) in the face-to-face group consulted general practitioners during the follow-up period (P=.03), and median number of consultations was 1 (IQR 0-13) and 1.5 (IQR 0-15), respectively (P=.19). Conclusions One-year remission rate from chronic headache was about 40% regardless of consultation form. Likewise, patient satisfaction with consultation and need for follow-up visits in general practice post consultation was similar. Treating chronic headache patients by using video consultations is not inferior to face-to-face consultations and may be used in clinical neurological practice. Trial Registration ClinicalTrials.gov NCT02270177; https://clinicaltrials.gov/ct2/show/NCT02270177

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“…SPINE20 calls upon the G20 countries to expand telehealth for spine care, especially due to the current ongoing situation with COVID-19 [ 12 ]. By taking this measure, patients with spinal diseases can obtain timely advice toward alleviating pain and recognizing critical symptoms that need urgent care, and thus obtaining treatment in a timely manner [ 13 ].…”

Section: Introduction Of Spine20mentioning

confidence: 99%

SPINE20 recommendations 2021: spine care for people’s health and prosperity

et al. 2022

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Purpose The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. Methods On September 17–18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations. These recommendations were uploaded to the SPINE20 website 10 days before the meeting and opened to the public for comments. The recommendations were discussed at the meeting allowing the participants to object and provide comments. Results In total, 27 societies endorsed the following recommendations. SPINE20 calls upon the G20 countries: (1) to expand telehealth for the access to spine care, especially in light of the current situation with COVID-19. (2) To adopt value-based interprofessional spine care as an approach to improve patient outcomes and reduce disability. (3) To facilitate access and invest in the development of a competent rehabilitation workforce to reduce the burden of disability related to spine disorders. (4) To adopt a strategy to promote daily physical activity and exercises among the elderly population to maintain an active and independent life with a healthy spine, particularly after COVID-19 pandemic. (5) To engage in capacity building with emerging countries and underserved communities for the benefit of spine patients. (6) To promote strategies to transfer evidence-based advances into patient benefit through effective implementation processes. Conclusions SPINE20’s initiatives will make governments and decision makers aware of efforts to reduce needless suffering from disabling spine pain through education that can be instituted across the globe.

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Systematic review of telemedicine in spine surgery

Cited by 19 publications

References 31 publications

Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

One-Year Remission Rate of Chronic Headache Comparing Video and Face-to-Face Consultations by Neurologist: Randomized Controlled Trial

SPINE20 recommendations 2021: spine care for people’s health and prosperity

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