For a study, researchers sought to develop and carry out a retrospective cohort research to compare patients who only had a telemedicine visit prior to surgery with those who had a telemedicine visit followed by an in-person evaluation prior to surgery to assess whether diagnoses and surgical plans made during a new patient telemedicine visit changed after an in-person evaluation. Data on telemedicine’s capacity to provide high-quality preoperative assessment without a conventional in-person conversation and physical examination were insufficient. The spine department at an urban tertiary hospital analyzed the records of patients who had new patient telemedicine visits between April 2020 and April 2021 and who indicated surgery with documented specific diagnoses as well as surgical plans. The diagnoses and plans were contrasted for a sample of patients who underwent a preoperative follow-up in-person evaluation. In addition, patients who only had a telemedicine visit prior to surgery were compared to those who had a telemedicine visit and an in-person evaluation. The perioperative outcomes for both groups of patients were also compared. There were 166 patients covered in all. In this group, 101 patients (61%) underwent surgery followed by just a new patient telemedicine visit, while 65 (39%) underwent surgery followed by a telemedicine visit and an in-person review. Patient-reported outcome indicators and the rate of case cancellations prior to surgery did not differ between these 2 groups (P>0.05). The diagnosis remained the same for 61 (94%) of the 65 patients who underwent telemedicine and an in-person visit, and the surgery plan remained the same for 52 (80%) patients. About 10 patients (77%) updated findings on new imaging were the primary cause of the surgical plan adjustment. According to the results of the study, telemedicine examinations can be a useful tool for spine patients undergoing preoperative evaluations.