1Division of Paediatric Neurosurgery and Craniofacial Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala.
2Department of Neurosurgery, Rangaraya Medical College, Kakinada, Andhra Pradesh.
Neurosurg Focus. 2024 Aug 1;57(2):E5. doi: 10.3171/2024.6.FOCUS24266.
In India, adult neurosurgeons are required to care for children regularly because the concept of dedicated pediatric specialty care is not yet entirely established in the subcontinent. Likewise, pediatric neurosurgeons do not exclusively offer their services to the young, but they also provide care to adult patients with neurosurgical disorders. This creates a medical system where the transition between specialties is not often a formal and recognized aspect of neurosurgical care because most neurosurgeons provide care for patients of all ages. Additionally, there are very few teams geared toward caring for conditions in children that merit lifelong medical support, with spina bifida (SB) being one of them. Since there are no focused or structured pediatric programs on a large scale, developing a multidisciplinary clinic for adults becomes challenging. A pragmatic approach using technology-based education, supported by an organized system or a coordinator, may be a new strategy. A new system utilizing telemedicine and smartphones for established patients maybe an alternative option for SB children in India. During virtual video conferences, an established patient may benefit from multispecialty care and education toward a smooth transition that avoids significant issues with time, transportation, or financial constraints. Achieving a seamless transition among allied specialists from the pediatric to adult systems is a utopia. The current system in the subcontinent may be improved, with an opportunity to develop smooth transition care between coordinated specialists (who simultaneously treat children and adults). Learning from various global SB management styles, the Indian transition situation may offer another model in the near future.
在印度,成人神经外科医生需要定期照顾儿童,因为小儿神经外科专业护理的概念在该次大陆尚未完全建立。同样,小儿神经外科医生不仅专门为年轻人提供服务,也为患有神经外科疾病的成年患者提供护理。这就形成了一种医疗体系,即专业之间的过渡通常不是神经外科护理的一个正式和公认的方面,因为大多数神经外科医生为所有年龄段的患者提供护理。此外,很少有专门的团队致力于治疗需要终身医疗支持的儿童疾病,其中包括脊柱裂(SB)。由于没有大规模的集中或结构化的儿科项目,为成人设立多学科诊所变得具有挑战性。一种基于技术的教育的实用方法,辅以有组织的系统或协调员,可能是一种新策略。对于印度的 SB 儿童来说,利用远程医疗和智能手机为已建立的患者提供新系统可能是一种替代方案。在虚拟视频会议期间,已建立的患者可以从多学科护理和教育中受益,以实现平稳过渡,避免因时间、交通或财务限制而产生重大问题。在小儿和成人系统之间实现联合专家的无缝过渡是一种理想状态。次大陆目前的系统可以得到改善,有机会在协调专家(同时治疗儿童和成人)之间发展平稳过渡护理。从各种全球 SB 管理模式中吸取经验,印度的过渡情况可能在不久的将来提供另一种模式。