Appropriate Telemedicine Utilization in Spine Surgery

Iyer, Sravisht; Bovonratwet, Patawut; Samartzis, D; Schoenfeld, Andrew J.; An, Howard S.; Awwad, Waleed; Blumenthal, Scott L.; Cheung, Jason; Derman, Peter B.; El-Sharkawi, Mohammad; Freedman, Brett A.; Härtl, Roger; Kang, James D; Kim, Hee Jin; Louie, Philip K.; Ludwig, Steven C.; Neva, Marko H.; Pham, Martin H.; Phillips, Frank M.; Qureshi, Sheeraz A.; Radcliff, Kris E.; Riew, K. Daniel; Sandhu, Harvinder S.; Sciubba, Daniel M.; Sethi, Rajiv K.; Valacco, Marcelo; Zaidi, Hasan A.; Zygourakis, Corinna C.; Makhni, Melvin C.

doi:10.1097/brs.0000000000004339

Cited by 12 publications

(16 citation statements)

References 25 publications

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“…This finding highlights the fact that telemedicine only preoperative assessment may not be appropriate for all types of diagnoses, especially ones that are highly dependent on the physical examination, such as cervical myelopathy. Indeed, a recent consensus study has shown that spine surgeons had consensus that an in-person visit before surgery is necessary after initial video telemedicine evaluation for cervical myelopathy 18. In addition, the surgeons had consensus that special tests for myelopathy were not possible to perform over a video-based visit 18.…”

Section: Discussionmentioning

confidence: 99%

“…18 In addition, the surgeons had consensus that special tests for myelopathy were not possible to perform over a video-based visit. 18 However, no consensus was reached on whether or not an in-person evaluation before surgery was necessary for lumbar stenosis and lumbar radiculopathy. 18 All together, these findings suggest that patients with lumbar stenosis or radiculopathy may be appropriately indicated for surgery through telemedicine alone.…”

Section: Discussionmentioning

confidence: 99%

“…18 However, no consensus was reached on whether or not an in-person evaluation before surgery was necessary for lumbar stenosis and lumbar radiculopathy. 18 All together, these findings suggest that patients with lumbar stenosis or radiculopathy may be appropriately indicated for surgery through telemedicine alone. However, even though patients with cervical disorders can be seen initially through telemedicine, a follow-up in-person evaluation should be strongly considered.…”

Section: Discussionmentioning

confidence: 99%

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Telemedicine Visits Can Generate Highly Accurate Diagnoses and Surgical Plans for Spine Patients

Bovonratwet

Song

Kim

et al. 2022

Spine

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Study Design. A Retrospective cohort study. Objective. To (1) assess whether diagnoses and surgical plans established during a new patient telemedicine visit changed following an in-person evaluation and (2) determine any differences in perioperative outcomes between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery. Summary of Background Data. Data on capability of telemedicine to deliver high-quality preoperative assessment without a traditional in-person interaction and physical examination is lacking. Materials and Methods. Records of patients who had a new patient telemedicine visit and indicated for surgery with documented specific diagnosis as well as surgical plans from a spine department at an urban tertiary center from April 2020 to April 2021 were reviewed. For a subset of patients that had a follow-up in-person evaluation before surgery, these diagnoses and plans were compared. Perioperative outcomes were compared between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery. Results. A total of 166 patients were included. Of these, 101 patients (61%) only had a new patient telemedicine visit before surgery while 65 (39%) had a telemedicine visit followed by an inperson evaluation. There were no differences in the rate of case cancellations before surgery and patient-reported outcome measures between these two groups (P > 0.05). Of 65 patients who had both a telemedicine followed by an in-person visit, the diagnosis was unchanged for 61 patients (94%) and the surgical plan did not change for 52 patients (80%). The main reason for surgical plan change was due to updated findings on new imaging, 10 patients, (77%). Conclusions. The current study suggests that telemedicine evaluations can provide an effective means of preoperative assessment for spine patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Telemedicine Visits Can Generate Highly Accurate Diagnoses and Surgical Plans for Spine Patients

Bovonratwet

Song

Kim

et al. 2022

Spine

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a recently published consensus document, we surveyed an international panel of spine surgeons using Delphi methodology to determine the visit types and diagnoses that could be evaluated using telemedicine. 6 The results demonstrated that patients with lumbar stenosis and lumbar radiculopathy could be indicated for surgery following a telemedicine evaluation. These findings are in keeping with data showing that surgical plans generally do not change for spine patients who had a virtual encounter prior to in-person pre-surgery evaluation.…”

mentioning

confidence: 93%

“…The same study suggested that for cervical myelopathy (where reflex and special testing is relatively more important) and adult deformity, an in-person evaluation is necessary prior to recommending surgery. 6 …”

mentioning

confidence: 99%