Telemedicine in Follow-up after Spine Surgery: Need of the Hour

Pankaj Totala, Vikas Janu, R. Sharma, Mohit Agrawal, M. Garg, J. Gosal, S. Bhaskar, D. Jha
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Abstract

Abstract Purpose  There is an acute shortage of neurosurgeons and spine surgeons especially in rural areas of low- and middle-income countries including India. Patients of spine surgery need to travel long distances for follow-up at tertiary care hospitals. This study was done to evaluate role and success rate of telemedicine in follow-up after spine surgery based on patients' diagnosis and demographic features and to identify barriers to successful telemedicine consultations. Methods  All patients undergoing spine surgeries including craniovertebral junction (CVJ) surgeries from January 2021 to June 2022 were included in the study. Success rate of telemedicine was calculated using a simple formula: Success rate of telemedicine = successful telemedicine consultations / total number of telemedicine consultation × 100. Success rate was evaluated with respect to demographic features and underlying disease-related factors. Results  Eighty-four patients formed the study group in which a total of 181 video teleconsultations were done. Overall success rate of telemedicine was 82.87%. Higher socioeconomic and educational statuses were related to higher success rates of tele-consultations ( p  < 0.05). Difficulty in assessing neurological condition using video call in follow-up cases of CVJ and issues related to Internet communication network leading to inability to video call and share image/videos were major causes of failures. Conclusion  Telemedicine may prove an effective option for following up patients undergoing spine surgeries except CVJ, which is likely to improve further with improvements in Internet connectivity.
脊柱手术后随访中的远程医疗:当务之急
摘要 目的 神经外科医生和脊柱外科医生严重短缺,尤其是在包括印度在内的中低收入国家的农村地区。脊柱手术患者需要长途跋涉到三级医院接受随访。本研究旨在根据患者的诊断和人口统计学特征,评估远程医疗在脊柱手术后随访中的作用和成功率,并找出成功进行远程医疗会诊的障碍。方法 将 2021 年 1 月至 2022 年 6 月期间接受脊柱手术(包括颅椎体交界处(CVJ)手术)的所有患者纳入研究。远程医疗的成功率用一个简单的公式计算:远程医疗成功率 = 远程医疗会诊成功率/远程医疗会诊总数 × 100。成功率的评估与人口统计学特征和基础疾病相关因素有关。结果 84 名患者组成了研究小组,共进行了 181 次视频远程会诊。远程医疗的总体成功率为 82.87%。较高的社会经济地位和教育程度与较高的远程会诊成功率有关(P < 0.05)。在 CVJ 随访病例中使用视频通话评估神经系统状况存在困难,以及与互联网通信网络相关的问题导致无法进行视频通话和共享图像/视频是失败的主要原因。结论 远程医疗可能被证明是对脊柱手术(CVJ 除外)患者进行随访的有效选择,随着互联网连接的改善,这种选择可能会得到进一步改善。
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