Tenkorang Pearl Ohenewaa, Awuah Wireko Andrew, Mannan Krishitha Meenu, Roy Subham, Nkrumah Boateng Princess Afia, Asiedu Olivia, Tahiru Marjidah, Ahluwalia Arjun, Owusu Bediako Nana Osei, Darko Kwadwo
University of Ghana Medical School, Accra, Ghana.
Department of Research, Toufik's World Medical Association, Sumy, Ukraine.
Brain Spine. 2025 Apr 29;5:104269. doi: 10.1016/j.bas.2025.104269. eCollection 2025.
Telemedicine has been integrated into healthcare systems for over two decades, with the COVID-19 pandemic accelerating its adoption across various medical fields, including neurosurgery. Low- and middle-income countries (LMICs) face significant challenges such as a shortage of neurosurgeons and inadequate healthcare infrastructure. Teleneurosurgery offers a crucial solution to these challenges, improving access to specialized care and enhancing patient outcomes in resource-constrained settings.
How has teleneurosurgery been used to enhance access to specialized neurological care and improve patient outcomes in low- and middle-income countries?
This narrative review employed a comprehensive search strategy to assess the role of telemedicine in neurosurgery within Low- and middle-income countries. Literature was searched across PubMed, EMBASE, and Scopus, using specific search terms related to teleneurosurgery, virtual consultations, and remote monitoring. Various study designs, including clinical trials, cohort studies, and case reports, were included, while isolated abstracts and unpublished studies were excluded. The review synthesizes the evidence to inform best practices in resource-limited environments.
Through remote consultations, pre-operative assessments and post-operative follow-up, telemedicine has become an essential tool to improve patient outcomes and increase access to neurosurgical care, particularly in underserved regions. The ability to conduct virtual assessments and provide specialized care remotely reduces the need for patients to travel long distances, thereby reducing the burden on already strained healthcare systems.
Despite its growing adoption, low- and middle-income countries continue to face challenges such as limited internet connectivity, regulatory barriers, and infrastructure deficiencies. However, mobile health solutions, international collaborations, and capacity-building initiatives are helping to overcome these obstacles. The future of teleneurosurgery in low- and middle-income countries is promising, but sustained investment in technology, training, and regulatory frameworks is essential to maximize its impact and address disparities in neurosurgical care.
远程医疗已融入医疗保健系统二十多年，新冠疫情加速了其在包括神经外科在内的各个医学领域的应用。低收入和中等收入国家（LMICs）面临着诸如神经外科医生短缺和医疗基础设施不足等重大挑战。远程神经外科为这些挑战提供了关键解决方案，在资源有限的环境中改善了获得专科护理的机会并提高了患者的治疗效果。
远程神经外科如何用于在低收入和中等收入国家增加获得专科神经护理的机会并改善患者治疗效果？
本叙述性综述采用全面的搜索策略来评估远程医疗在低收入和中等收入国家神经外科中的作用。在PubMed、EMBASE和Scopus上进行文献搜索，使用与远程神经外科、虚拟会诊和远程监测相关的特定搜索词。纳入了各种研究设计，包括临床试验、队列研究和病例报告，同时排除了单独的摘要和未发表的研究。该综述综合证据以指导资源有限环境中的最佳实践。
通过远程会诊、术前评估和术后随访，远程医疗已成为改善患者治疗效果和增加获得神经外科护理机会的重要工具，特别是在服务不足的地区。进行虚拟评估和远程提供专科护理的能力减少了患者长途跋涉的需求，从而减轻了本已不堪重负的医疗系统的负担。
尽管远程医疗的应用日益广泛，但低收入和中等收入国家仍然面临诸如互联网连接有限、监管障碍和基础设施不足等挑战。然而，移动健康解决方案、国际合作和能力建设举措正在帮助克服这些障碍。低收入和中等收入国家远程神经外科的未来很有希望，但对技术、培训和监管框架的持续投资对于最大限度地发挥其影响并解决神经外科护理方面的差距至关重要。
