Telemedicine in Spine Surgery: Global Perspectives and Practices.

Abstract

STUDY DESIGN\nCross-sectional, anonymous, international survey.\n\n\nOBJECTIVES\nThe 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.\n\n\nMETHODS\nAll 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.\n\n\nRESULTS\n485 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.\n\n\nCONCLUSION\nOur 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.