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

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

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.