Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

Grant J. Riew, Francis Lovecchio, Dino Samartzis, David N. Bernstein, Ellen Y. Underwood, Philip K. Louie, Niccole Germscheid, Howard S. An, Jason Pui Yin Cheung, Norman Chutkan, Gary Michael Mallow, Marko H. Neva, Frank M. Phillips, Daniel M. Sciubba, Mohammad El-Sharkawi, Marcelo Valacco, Michael H. McCarthy, Sravisht Iyer, Melvin C. Makhni

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: While telemedicine usage has increased due to the COVID-19 pandemic, there remains little consensus about how spine surgeons perceive virtual care. The purpose of this study was to explore international perspectives of spine providers on the challenges and benefits of telemedicine. Methods: Responses from 485 members of AO Spine were analyzed, covering provider perceptions of the challenges and benefits of telemedicine. All questions were optional, and blank responses were excluded from analysis. Results: The leading challenges reported by surgeons were decreased ability to perform physical examinations (38.6%), possible increased medicolegal exposure (19.3%), and lack of reimbursement parity compared to traditional visits (15.5%). Fewer than 9.0% of respondents experienced technological issues. On average, respondents agreed that telemedicine increases access to care for rural/long-distance patients, provides societal cost savings, and increases patient convenience. Responses were mixed about whether telemedicine leads to greater patient satisfaction. North Americans experienced the most challenges, but also thought telemedicine carried the most benefits, whereas Africans reported the fewest challenges and benefits. Age did not affect responses. Conclusion: Spine surgeons are supportive of the benefits of telemedicine, and only a small minority experienced technical issues. The decreased ability to perform the physical examination was the top challenge and remains a major obstacle to virtual care for spine surgeons around the world, although interestingly, 61.4% of providers did not acknowledge this to be a major challenge. Significant groundwork in optimizing remote physical examination maneuvers and achieving legal and reimbursement clarity is necessary for widespread implementation.

Original languageEnglish (US)
Pages (from-to)2124-2132
Number of pages9
JournalEuropean Spine Journal
Issue number8
StatePublished - Aug 2021


  • Benefits
  • Challenges
  • Global
  • Spine surgery
  • Telemedicine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


Dive into the research topics of 'Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study'. Together they form a unique fingerprint.

Cite this