Telemedicine in Spine Surgery: Global Perspectives and Practices

Abstract

Study Design: Cross-sectional, anonymous, international survey. Objectives: The COVID-19 pandemic has resulted in the rapid adoption of telemedicine in spine surgery. This study sought to determine the extent of adoption and global perspectives on telemedicine in spine surgery. Methods: All members of AO Spine International were emailed an anonymous survey covering the participant’s experiences with and perceptions of telemedicine. Descriptive statistics were used to depict responses. Responses were compared among regions. Results: 485 spine surgeons participated in the survey. Telemedicine usage rose from <10.0% to >39.0% of all visits. A majority of providers (60.5%) performed at least one telemedicine visit. The format of “telemedicine” varied widely by region: European (50.0%) and African (45.2%) surgeons were more likely to use phone calls, whereas North (66.7%) and South American (77.0%) surgeons more commonly used video ( P < 0.001). North American providers used telemedicine the most during COVID-19 (>60.0% of all visits). 81.9% of all providers “agreed/strongly agreed” telemedicine was easy to use. Respondents tended to “agree” that imaging review, the initial appointment, and postoperative care could be performed using telemedicine. Almost all (95.4%) surgeons preferred at least one in-person visit prior to the day of surgery. Conclusion: Our study noted significant geographical differences in the rate of telemedicine adoption and the platform of telemedicine utilized. The results suggest a significant increase in telemedicine utilization, particularly in North America. Spine surgeons found telemedicine feasible for imaging review, initial visits, and follow-up visits although the vast majority still preferred at least one in-person preoperative visit.

Telemedicine in Spine Surgery During COVID-19

“…We would like to share ideas on “Telemedicine in Spine Surgery: Global Perspectives and Practices.” 1 Riew et al concluded that “ Our study noted significant geographical differences in the rate of telemedicine adoption and the platform of telemedicine utilized .” 1 We totally agree about the disequilibrium in using telemedicine for spine surgery in different areas. In our area, facilities of internet are usually limited and there are also limited number of physician who can perform spine surgery.…”

Improving patient care in neurosurgery through postoperative telephone calls: a systematic review and lessons from all surgical specialties

“…Use of telemedicine by spine surgeons has grown from 10% to more than 39% of all visits during the COVID-19 pandemic. 31 Some studies have shown that telemedicine visits can be as effective as in-person visits in an orthopedic patient population. 32 Although the cases of many neurosurgical patients may be more complicated and require in-person neurological examinations, postoperative telemedicine check-ins may prove to be a feasible option for routine procedures in uncomplicated cases.…”

“…Up to 50% of telemedicine users have experienced technical difficulties during at least 15% of visits. 31 When implemented correctly, however, it can be a useful adjunct to in-person visits while maintaining safety. A 2021 systematic review by Ng et al found that surgical site infections could be diagnosed via telemedicine 70% to 100% of the time compared with in-person examinations.…”

Telemedicine: Could it represent a new problem for spine surgeons to solve?

“…(25%). 1 Although telemedicine is showing to provide convenient and safety health care to patients during COVID-19 pandemic, there is still much uncertainty as to whether it will have a permanent role in treating spine patients. 3 Although telemedicine is a new and rapidly evolving field, it is important to pay attention to potential malpractice litigation in telemedicine that could occur, as misdiagnoses or failure to identify pressing issues at home may create legal implications.…”