Telemedicine in Spine Surgery During COVID-19.

We would like to share ideas on “Telemedicine in Spine Surgery: Global Perspectives and Practices.” Riew et al concluded that “Our study noted significant geographical differences in the rate of telemedicine adoption and the platform of telemedicine utilized.” We totally agree about the disequilibrium in using telemedicine for spine surgery in different areas. In our area, facilities of internet are usually limited and there are also limited number of physician who can perform spine surgery. Agree or disagree with telemedicine might reflect attitude, however, the availability of technologies in resource limited setting is still the big barrier for telemedicine in spine surgery. To realize the current situation in resource limited settings might help explain the attitude of practitioners. In fact, similar observation is also reported on attitude of patients receiving care from neurosurgery clinic. Distance might be a reason, but not significant, factor leading to “agree” with telemedicine service. In the areas that internet is available, an internet traffic jam also occurs. Additionally, the telemedicine cannot replace the real physical examination in case with neurological problem due to spine disease. These might be reasons that some practitioners give ideas “disagree.”