Culpepper Sylvia, Murphy Robert F, Clement R Carter
Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.
Spine Deform. 2025 May;13(3):951-959. doi: 10.1007/s43390-024-01021-8. Epub 2024 Dec 14.
To investigate the adoption and sustained use of telehealth for managing early-onset scoliosis (EOS) during and after the COVID-19 pandemic.
A 35-question anonymous survey was emailed to 191 physician members of an international pediatric spine research group.
Ninety seven clinicians completed the survey (51%). Of the 78% who reported that they currently use telehealth for EOS patients, 44% do so rarely; 21% do not use telehealth at all for EOS patients. Pre-pandemic, 37% used telehealth, increasing to 93% during the pandemic, with 40% using telehealth for most visits and 33% for a quarter of visits (p < 0.001). Post-pandemic usage was significantly higher than pre-pandemic levels (p < 0.001). Bracing was the favored treatment to monitor via telehealth (61% of respondents). Minor curves and initial post-op visits were ranked as the most suitable for remote care (77% of respondents). Geography and transport issues were the most cited drivers of telehealth (71% and 57% of respondents, respectively). No specific subset of EOS was particularly suitable for telehealth. The most common exam techniques used via telehealth included back inspection (88%), observing gait/posture (58%), and Adams test (46%).
The COVID-19 pandemic saw a significant increase in telehealth services for EOS patients (p < 0.001). While most patients returned to in-person visits post-pandemic, a significant number continued to use telehealth, especially when compared to pre-pandemic (p < 0.001). This persistent use, particularly for patients treated with bracing and to monitor minor curves, highlights the opportunity to optimize EOS care by strategically blending telemedicine with conventional clinic visits.
调查在新冠疫情期间及之后远程医疗在早发性脊柱侧弯（EOS）管理中的采用情况和持续使用情况。
向一个国际儿科脊柱研究小组的191名医生成员发送了一份包含35个问题的匿名调查问卷。
97名临床医生完成了调查（51%）。在报告目前为EOS患者使用远程医疗的78%的人中，44%很少使用；21%根本不为EOS患者使用远程医疗。疫情前，37%的人使用远程医疗，疫情期间这一比例增至93%，其中40%在大多数就诊时使用远程医疗，33%在四分之一的就诊时使用（p<0.001）。疫情后的使用情况显著高于疫情前水平（p<0.001）。支具治疗是最适合通过远程医疗监测的治疗方法（61%的受访者）。轻度侧弯和术后初次就诊被列为最适合远程护理的情况（77%的受访者）。地理位置和交通问题是远程医疗最常被提及的推动因素（分别为71%和57%的受访者）。没有特定的EOS亚组特别适合远程医疗。通过远程医疗使用的最常见检查技术包括背部检查（88%）、观察步态/姿势（58%）和亚当斯试验（46%）。
新冠疫情期间，为EOS患者提供的远程医疗服务显著增加（p<0.001）。虽然大多数患者在疫情后恢复了面对面就诊，但仍有相当一部分患者继续使用远程医疗，特别是与疫情前相比（p<0.001）。这种持续使用，特别是对于接受支具治疗的患者和监测轻度侧弯的情况，凸显了通过将远程医疗与传统门诊就诊策略性结合来优化EOS护理的机会。
