Neurosurgical Practice and Training During COVID-19 Pandemic

The COVID-19 pandemic posed unprecedented challenges to neurosurgical services worldwide, compelling rapid adaptation in clinical pathways, resource allocation and educational delivery. Elective procedures were curtailed to preserve critical care capacity, while emergency and urgent interventions continued under stringent infection-control protocols. Clinical teams introduced streamlined perioperative workflows, accelerated patient discharge and minimised intensive care usage without compromising outcomes. Concurrently, training programmes pivoted from hands-on experience towards virtual platforms, webinars and simulation-based learning to maintain educational continuity. Trainees faced reduced operative exposure and redeployment to frontline care, prompting innovative approaches to competence assessment and mental well-being support. As restrictions eased, many centres saw a rebound in case volumes and integrated hybrid models combining remote education with restored surgical curricula. Lessons from this period have informed resilient strategies for sustaining high-quality neurosurgical care and training in ongoing and future crises.

Research from Nature Portfolio

Analyses of non-elective neurosurgical cases across multiple European centres during the first pandemic wave revealed a marked decline in incidence of traumatic brain injuries, spine conditions and chronic subdural haematomas, driven largely by mobility restrictions. Despite lower case numbers, 30-day mortality rates remained comparable to pre-pandemic years, indicating preservation of care quality under pandemic pressures. A follow-up study during the third wave demonstrated a recovery in emergency case volumes to near pre-pandemic levels without a rise in perioperative morbidity, underscoring the effectiveness of refined screening protocols and dedicated pathways for COVID-negative patients. These findings illustrate that concerted international collaboration and adaptive care models can maintain critical neurosurgical services in the face of fluctuating healthcare demands and public health constraints.

Neurosurgical Practice and Training During COVID-19 Pandemic publication trend

The graph below shows the total number of articles in neurosurgical practice and training during covid-19 pandemic across all publications each year (not limited to Nature Index journals).

Technical terms

Elective surgery: A non-urgent procedure scheduled in advance of hostilities to optimise resource use.

Non-elective neurosurgical case: An urgent or emergency operation that cannot be safely postponed without risk to patient outcome.

Telemedicine: Delivery of clinical services remotely via digital communication platforms to reduce in-person contact.

Simulation-based training: Use of virtual reality or physical models to replicate surgical scenarios for skill acquisition and assessment.

Lower- and middle-income countries (LMICs): Nations classified by international bodies based on gross national income thresholds, often with constrained healthcare resources.

References

1. The Impact of the COVID-19 Pandemic in Postoperative Neurosurgical Infections at a Reference Center in México. Antibiotics (2023).
2. Need for ensuring care for neuro-emergencies—lessons learned from the COVID-19 pandemic. Acta Neurochirurgica (2020).
3. Neurosurgery and coronavirus: impact and challenges—lessons learnt from the first wave of a global pandemic. Acta Neurochirurgica (2020).
4. The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review. Neurosurgical Review (2021).
5. The Impact of the Coronavirus Pandemic on European Neurosurgery Trainees. World Neurosurgery (2021).
6. Trends and outcomes for non-elective neurosurgical procedures in Central Europe during the COVID-19 pandemic. Scientific Reports (2021).
7. Current trends and outcomes of non-elective neurosurgical care in Central Europe during the second year of the COVID-19 pandemic. Scientific Reports (2022).