The evolution of telehealth in early-onset scoliosis care throughout the COVID-19 pandemic.

Abstract

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.