Development of a Telemedicine Neurological Examination for Spine Surgery: A Pilot Trial. Issue 9 (November 2020)

• Record Type: Journal Article
• Authors: Goyal, Dhruv K.C.; Divi, Srikanth N.; Schroeder, Gregory D.; Pfeifer, Ryan; Canseco, Jose A.; Bowles, Daniel R.; Nicholson, Kristen J.; Patel, Parthik D.; Reyes, Ariana A.; Radcliff, Kristen E.; Kurd, Mark F.; Woods, Barrett I.; Kaye, Ian David; Rihn, Jeffrey A.; Anderson, David Greg; Hilibrand, Alan S.; Kepler, Christopher K.; Harrop, James S.; Vaccaro, Alexander R.
• Is Part Of: Clinical spine surgery. Volume 33:Issue 9(2020)
• Publication Date: 2020-11
• Subjects: telemedicine -- telehealth -- remote medicine -- neurological examination -- spine surgery -- orthopedic surgery -- spine surgery -- neurosurgery -- value-based care; Spinal cord -- Diseases -- Periodicals; Spinal cord -- Surgery -- Periodicals; 617.56059
• DOI: 10.1097/BSD.0000000000001066
• Languages: English
• ISSNs: 2380-0186

Abstract

Abstract : Study Design: This was a prospective cohort study. Objective: The objective of this study was to design and test a novel spine neurological examination adapted for telemedicine. Summary of Background Data: Telemedicine is a rapidly evolving technology associated with numerous potential benefits for health care, especially in the modern era of value-based care. To date, no studies have assessed whether. Methods: Twenty-one healthy controls and 20 patients with cervical or lumbar spinal disease (D) were prospectively enrolled. Each patient underwent a telemedicine neurological examination as well as a traditional in-person neurological examination administered by a fellowship trained spine surgeon and a physiatrist. Both the telemedicine and in-person tests consisted of motor, sensory, and special test components. Scores were compared via univariate analysis and secondary qualitative outcomes, including responses from a satisfaction survey, were obtained upon completion of the trial. Results: Of the 20 patients in the D group, 9 patients had cervical disease and 11 patients had lumbar disease. Comparing healthy control with the D group, there were no significant differences with respect to all motor scores, most sensory scores, and all special tests. There was a high rate of satisfaction among the cohort with 92.7% of participants feeling "very satisfied" with the overall experience. Conclusions: This study presents the development of a viable neurological spine examination adapted for telemedicine. The findings in this study suggest that patients have comparable motor, sensory, and special test scores with telemedicine as with a traditional in-person examination administered by an experienced clinician, as well as reporting a high rate of satisfaction among participants. To our knowledge, this is the first telemedicine neurological examination for spine surgery. Further studies are warranted to validate these findings. Abstract : Supplemental Digital Content is available in the text.