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. 2023 Jul 17;2(3):100260.
doi: 10.1016/j.inpm.2023.100260. eCollection 2023 Sep.

Feasibility and effectiveness of telehealth in the management of cervicothoracic and lumbar pain during the first six months of the SARS-CoV-2 pandemic: A case series

George Rappard  1   2 , Jake Harb  1 , Caitlin Yi  1 , Robb Russell  2
Affiliations

Feasibility and effectiveness of telehealth in the management of cervicothoracic and lumbar pain during the first six months of the SARS-CoV-2 pandemic: A case series

George Rappard et al. Interv Pain Med. .

Abstract

Objectives: The primary study objective is to assess the effectiveness and utility of telehealth in managing spine pain. The secondary objective is to evaluate the feasibility of employing various treatments utilizing telehealth.

Study design: Retrospective case series of patients with spinal pain managed primarily by telehealth during the first 6 months of the SARS-CoV-2 pandemic in the United States.

Setting: A single center community based out-patient clinic and ambulatory surgical facility.

Subjects: 101 consecutive adult patients complaining of cervicothoracic or low back pain presenting to a specialized spine clinic.

Methods: Telehealth was the preferred method of consultation for 101 consecutive patients presenting with cervicothoracic and/or low-back pain. After conservative care, patients with continued pain and disability were offered procedures. Disability Index (NDI and ODI) and pain Visual Analog Scores (VAS) were used to determine patient outcomes.

Results: 101 new out-patient consultations occurred. Telehealth initial consultation occurred in 98% of cases. There was a total of 504 follow up consultations. Follow up was via telehealth in 69%. Significant neurological abnormalities were detected by telehealth in 3% of patients. The lost to follow up rate was 10%. All 63 interventional procedures performed on 42 patients were completed as planned during telehealth visits. Likewise for all 9 surgical procedures. Outcomes were monitored via telehealth. Overall, for patients with cervicothoracic pain, minimal clinically important differences (MCID) for VAS or NDI were reached in 71%. Overall, the MCID for VAS or ODI for low back pain patients was reached in 70%.

Conclusion: Telehealth in our series was easily deployable, highly feasible, allowed accurate monitoring of patient care and resulted in accurate triaging for interventions and surgery. Overall patient outcomes compare favorably with that reported for in-person spinal pain care. Telehealth was effective and easily utilizable.

Keywords: Conservative care; Interventional care; Low back pain; Neck pain; SARS-CoV-2 pandemic; Telehealth.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Patient treatment flow.
Fig. 2
Fig. 2
Cervicothoracic pain treatment flow.
Fig. 3
Fig. 3
Mean Visual Analog Scores (VAS) in cervicothoracic pain patients.
Fig. 4
Fig. 4
Mean Neck Disability Index (NDI) scores in cervicothoracic pain patients.
Fig. 5
Fig. 5
Cervicothoracic patients reaching MCID for VAS or NDI overall, after conservative care and after interventional procedures.
Fig. 6
Fig. 6
Low back pain treatment flow.
Fig. 7
Fig. 7
Mean Visual Analog Scores (VAS) in low back pain patients.
Fig. 8
Fig. 8
Mean Oswestry Disability Index (ODI) scores in low back pain patients.
Fig. 9
Fig. 9
Low back pain patients reaching MCID for VAS or NDI overall, after conservative care, after interventional procedures and after surgery.
See this image and copyright information in PMC

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