Comparative Outcomes of Telemedicine vs. In-person Care in Postoperative Management of Spine Surgery: A Literature Review

Document Type

Article

Publication Title

Journal of the American Osteopathic Academy of Orthopedics

Abstract

Introduction
Spine surgery addresses a wide range of degenerative, traumatic, and deformity-related conditions. Postoperative care is critical to outcomes but challenged by complications, adherence barriers, and limited access. Telemedicine, rapidly expanded during the COVID-19 pandemic, has demonstrated feasibility across surgical specialties and offers a potential solution to improve access, reduce follow-up barriers, and enhance recovery. However, its role in spine surgery follow-up remains incompletely defined.

Methods
A systematic review was conducted of PubMed, Embase, Scopus, Cochrane Library, and Google Scholar (2000–2025) to identify English-language studies evaluating telemedicine interventions in spine surgery care. Eligible designs included randomized controlled trials, cohort studies, case series, and systematic reviews. Primary outcomes included surgical site infections (SSI), readmissions, reoperations, and adherence. Secondary outcomes included emergency utilization and patient satisfaction. Data were extracted and synthesized narratively. Two reviewers independently screened and extracted data, resolving discrepancies by consensus.

Results
In spine-specific cohorts, no differences were found in operative complications, reoperations, or six-month readmissions. Improved functional outcomes were reported with telemedicine patients showing greater Functional Independence Measure (FIM) score gains. Patient satisfaction was consistently high, with most spine patients reporting satisfaction. However, only a majority of patients preferred telemedicine for follow-up. Video-based encounters were rated significantly higher than audio-only visits. Integration of digital tools, including wearable accelerometers and mobile health applications, enhanced adherence, enabled early complication detection, and demonstrated a high retention rate with preliminary improvements in pain and disability scores. Reported barriers included the inability to conduct comprehensive neurological examinations, socioeconomic disparities, limited digital literacy, and variability in institutional protocols.

Conclusion
Collectively, the current literature warrants a conservative interpretation, when inspecting the promise of telemedicine in both preoperative and postoperative spinal care. Despite increasing utilization, challenges remain, including physical exam limitations, disparities in digital access, and heterogeneity in study design. While early findings suggest telemedicine outcomes comparable to traditional care, larger multicenter trials with adequate power are required to clarify timing, implementation, and patient selection, and to establish evidence-based recommendations for broader adoption.

DOI

10.70709/kn07qjczv

Publication Date

Fall 2025

Keywords

Spine surgery, telemedicine, telehealth, postoperative management, postoperative outcomes

ISSN

2996-1742

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