• Ivan B Ye, Alexandra E Thomson, Jack Donahue, Brittany Oster, Vincent S Miseo, Julio J Jauregui, Daniel Cavanaugh, Eugene Koh, Daniel Gelb, and Steven Ludwig.
• Department of Orthopaedic Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA.
• World Neurosurg. 2022 Aug 1; 164: e1043-e1048.

ObjectiveThe aim of this study was to compare accuracy of surgical plans generated from in-person and telemedicine evaluations and assess the reasons for surgical plan changes between initial evaluation and surgery. The secondary objective was to assess the effect of changes in surgical planning on postoperative outcomes.MethodsIn this retrospective cohort study, consecutive patients who were evaluated as new patients by orthopaedic spine faculty between 2019 and 2021 were divided by appointment type: telemedicine (n = 39) and in-person (n = 92). Patients were included if the surgeon documented a definitive surgical plan at the initial visit. The primary outcome was change in surgical plan from initial assessment to actual procedure performed.ResultsThere was no significant difference in the accuracy of initial surgical plans between the telemedicine and in-person cohorts (79.5% vs. 82.6%, P = 0.673). The most common modification in the surgical plan (79%) was change in the number of operated levels, of which 18 of 19 patients had 1 added operated level. Less common reasons were change in approach (13%) and change in procedure (8%). Patients with changes to their surgical plan experienced longer length of stay (3.1 vs. 2.0 days, P = 0.027) than patients with consistent surgical plans.ConclusionsTelemedicine and in-person evaluations generated similarly accurate surgical plans. Changes to the initial surgical plans most often involved adding operative levels. Our findings show that telemedicine visits are an acceptable option for preoperative assessment to generate surgical plans; however, further research is needed.Copyright © 2022 Elsevier Inc. All rights reserved.

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