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

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)355-369
Number of pages15
JournalClinical spine surgery
Issue number9
StatePublished - Nov 2020


  • neurological examination
  • neurosurgery
  • orthopedic surgery
  • remote medicine
  • spine surgery
  • telehealth
  • telemedicine
  • value-based care

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine


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