{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:43:44Z","timestamp":1761198224769,"version":"3.30.1"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Telemedicine encounters are expanding in utility for outpatient care and evaluation, partially as a necessity during the COVID-19 pandemic. It is unclear if telemedicine evaluation is comparable to in-person assessment of patients with spinal pathology undergoing surgical consultation. The objective of this study was to determine if treatment plans change for spine patients evaluated in person following an initial telemedicine consultation.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Patients referred to the authors\u2019 comprehensive spine center were evaluated first via telemedicine and then in clinic. Telemedicine evaluations were conducted via video evaluation with an attending surgeon. Demographic data including age, gender, and distance traveled from the clinic were retrospectively recorded. A chart review retrieved symptoms, radiographic details, and past medical history. The primary outcome was if the treatment plan changed (plan change [PC]) after seeing the patient in the clinic. Chi-square tests and binary logistical regression produced uni- and multivariate analyses.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>There were 152 new patients seen via telemedicine and in person. Pathology was present in the cervical (28.3%), thoracic (9.9%), and lumbar (61.8%) spine. The most common symptom was pain (72.4%), followed by radiculopathy (66.4%), weakness (26.3%), myelopathy (15.1%), and claudication (12.5%). There were 37 patients (24.3%) for whom there was a PC after clinic evaluation, and of those, only 5 (3.3%) were due to physical examination (PCPE) findings. On univariate analysis, a longer duration between telemedicine and clinic visit (odds ratio [OR] 1.094 per 7 days, p = 0.003), having pathology in the thoracic spine (OR 3.963, p = 0.018) and lack of sufficient imaging (OR 25.455, p &lt; 0.0001) were predictive of a PC. Having pathology in the cervical spine (OR 9.538, p = 0.047) and adjacent-segment disease (OR 11.471, p = 0.010) were predictive of a PCPE.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This study demonstrates that telemedicine may be an effective modality for the initial evaluation of spine surgical patients, without compromising decision-making in the absence of an in-person physical examination.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.5.spine23182","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T07:32:57Z","timestamp":1688196777000},"page":"600-606","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of patients referred to the spine clinic via telemedicine and the impact on diagnosis and surgical decision-making"],"prefix":"10.3171","volume":"39","author":[{"given":"Kaitlyn","family":"Melnick","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Porche","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai","family":"Sriram","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Goutnik","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micaela","family":"Cuneo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Murad","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nohra","family":"Chalouhi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Polifka","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Hoh","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Decker","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"18","key":"b1","series-title":"N Engl J Med","first-page":"1679","article-title":"Virtually perfect? 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Clin Spine Surg. 2020;33(9):355\u2013369."},{"issue":"suppl 1","key":"b8","series-title":"HSS J","first-page":"77","article-title":"Early peri-operative outcomes were unchanged in patients undergoing spine surgery during the COVID-19 pandemic in New York City","volume":"16","author":"Louie PK","year":"2020","unstructured":"Louie PK, Barber LA, Morse KW,  Early peri-operative outcomes were unchanged in patients undergoing spine surgery during the COVID-19 pandemic in New York City. HSS J. 2020;16(suppl 1):77\u201384."},{"issue":"8","key":"b9","series-title":"J Telemed Telecare","first-page":"451","article-title":"Patient reported outcomes with remote orthopaedic consultations by telemedicine: a aitlyned controlled trial","volume":"25","author":"Buvik A","year":"2019","unstructured":"Buvik A, Bugge E, Knutsen G, Sm\u00e5brekke A, Wilsgaard T. Patient reported outcomes with remote orthopaedic consultations by telemedicine: a aitlyned controlled trial. 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Mayo Clin Proc. 2020;95(8):1715\u20131731."},{"issue":"7","key":"b12","series-title":"Global Spine J","first-page":"1142","article-title":"Physical examination of the spine using telemedicine: a systematic review","volume":"11","author":"Piche J","year":"2021","unstructured":"Piche J, Butt BB, Ahmady A, Patel R, Aleem I. Physical examination of the spine using telemedicine: a systematic review. Global Spine J. 2021;11(7):1142\u20131147."},{"key":"b13","series-title":"World Neurosurg","first-page":"e781","article-title":"A multicenter evaluation of the feasibility, patient\/provider satisfaction, and value of virtual spine consultation during the COVID-19 pandemic","volume":"154","author":"Hobson S","year":"2021","unstructured":"Hobson S, Aleem IS, Bice MJ,  A multicenter evaluation of the feasibility, patient\/provider satisfaction, and value of virtual spine consultation during the COVID-19 pandemic. World Neurosurg. 2021;154:e781\u2013e789."},{"issue":"3","key":"b14","series-title":"Spine J","first-page":"359","article-title":"Surgical plans generated from telemedicine visits are rarely changed after in-person evaluation in spine patients","volume":"21","author":"Lightsey HM IV","year":"2021","unstructured":"Lightsey HM IV, Crawford AM, Xiong GX, Schoenfeld AJ, Simpson AK. Surgical plans generated from telemedicine visits are rarely changed after in-person evaluation in spine patients. Spine J. 2021;21(3):359\u2013365."},{"issue":"6","key":"b15","series-title":"Reg Anesth Pain Med","first-page":"478","article-title":"Interventional procedure plans generated by telemedicine visits in spine patients are rarely changed after in-person evaluation","volume":"46","author":"Crawford AM","year":"2021","unstructured":"Crawford AM, Lightsey HM, Xiong GX,  Interventional procedure plans generated by telemedicine visits in spine patients are rarely changed after in-person evaluation. Reg Anesth Pain Med. 2021;46(6):478\u2013481."},{"issue":"11","key":"b16","series-title":"Arch Orthop Trauma Surg","first-page":"3009","article-title":"Telemedicine visits generate accurate surgical plans across orthopaedic subspecialties","volume":"142","author":"Crawford AM","year":"2022","unstructured":"Crawford AM, Lightsey HM, Xiong GX, Striano BM, Schoenfeld AJ, Simpson AK. Telemedicine visits generate accurate surgical plans across orthopaedic subspecialties. Arch Orthop Trauma Surg. 2022;142(11):3009\u20133016."},{"key":"b17","series-title":"Front Pediatr","first-page":"713930","article-title":"COVID-19 era effect on pandemic and post-pandemic pediatric telemedicine use: a survey of the European Academy of Pediatrics Research in Ambulatory Settings Network","volume":"9","author":"Reingold SM","year":"2021","unstructured":"Reingold SM, Hadjipanayis A, van Esso D,  COVID-19 era effect on pandemic and post-pandemic pediatric telemedicine use: a survey of the European Academy of Pediatrics Research in Ambulatory Settings Network. 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