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. 2020 Nov;33(9):355-369.
doi: 10.1097/BSD.0000000000001066.

Development of a Telemedicine Neurological Examination for Spine Surgery: A Pilot Trial

Dhruv K C Goyal  1 , Srikanth N Divi  1 , Gregory D Schroeder  1 , Ryan Pfeifer  1 , Jose A Canseco  1 , Daniel R Bowles  1 , Kristen J Nicholson  1 , Parthik D Patel  1 , Ariana A Reyes  1 , Kristen E Radcliff  1 , Mark F Kurd  1 , Barrett I Woods  1 , Ian David Kaye  1 , Jeffrey A Rihn  1 , David Greg Anderson  1 , Alan S Hilibrand  1 , Christopher K Kepler  1 , James S Harrop  1   2 , Alexander R Vaccaro  1
Affiliations

Development of a Telemedicine Neurological Examination for Spine Surgery: A Pilot Trial

Dhruv K C Goyal et al. Clin Spine Surg. 2020 Nov.

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.

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