Impact of the COVID-19 Pandemic on Neurosurgical Practice

Newswise — Charlottesville, VA (April 10, 2020). The COVID-19 pandemic has had an enormous effect on medical practice across the globe. This is obvious for the fields of infectious disease, virology, emergency and critical care medicine, and epidemiology, but also holds true for other medical specialties including neurosurgery.

Beginning on April 10th, the Journal of Neurosurgery Publishing Group (JNSPG), the scholarly journal division of the American Association of Neurological Surgeons, presents a series of editorials on the impact of the COVID-19 pandemic on the practice of neurosurgery. Today we offer an introduction to the series by the editors of the JNSPG as well as three editorials: one written by Chinese neurosurgeons, the second by Italian neurosurgeons, and the third by the leadership of the American Society of Pediatric Neurosurgeons. Additional papers on this topic will appear each Friday on the JNSPG website (www.thejns.org) as they become available.

In their series introduction, Drs. Douglas S. Kondziolka, William T. Couldwell, and James T. Rutka broadly address the impact the pandemic has had on neurosurgical practice. Certain operative procedures have to be adjusted to protect the neurosurgical team from exposure to the virus. Neurosurgeries must be prioritized, delaying less urgent cases so that greater hospital facilities and equipment can be made available for patients with COVID-19. Medical student and resident training formats and schedules have been changed dramatically. Scientific meetings have been canceled or delayed.

The editors of the JNSPG solicited editorials worldwide to address these and other topics related to neurosurgical practice in the face of the pandemic. Three of these editorials appear on our website today.

• Yirui Sun and Ying Mao provide an update on the pandemic in China. They speak of colleagues lost and the efforts of neurosurgeons to treat emergency cases regardless of the viral status of their patients. The authors also speak of how COVID-19 has given them “pause to reinforce [their] skillsets and redesign [their] mindsets to perform roles not only as neurosurgeons but also as executive officers.”

• Marco Cenzato and colleagues speak from “the storm of COVID-19” in the Lombardi region of Italy, yet show how sometimes “ex malo bonum” (out of bad comes good). They describe a reorganization of neurosurgical facilities to expand the number of ICUs available to COVID-19 patients. Fifteen neurosurgical departments were temporarily consolidated into three locations, with neurosurgeons and patients shifted as well. As a result, “opening the hospital doors to neurosurgeons coming from other institutions has offered an unprecedented opportunity of collaboration and integration of teams.” 

• Leaders of the American Society of Pediatric Neurosurgeons address current management of COVID-19 in the pediatric neurosurgery community and provide recommendations on the preparation and response to the pandemic. Crucial areas addressed in their recommendations include children’s hospitals as a whole, operating rooms, pediatric neurosurgery clinical teams, and patients. Serious illness remains relatively rare among children with COVID-19; nevertheless, the authors warn against complacency and stress the need for urgency in preparation and response to the pandemic.

Join us in reading the following articles about neurosurgeons’ experiences and lessons learned thus far during the COVID-19 pandemic. All articles are free to the public.

Kondziolka D, Couldwell WT, Rutka JT: Introduction. On pandemics: the impact of COVID-19 on the practice of neurosurgery, Journal of Neurosurgery, published online, ahead of print, April 10, 2020. https://thejns.org/doi/abs/10.3171/2020.3.JNS201007

Sun Y, Mao Y: Editorial. Response to COVID-19 in Chinese neurosurgery and beyond. Journal of Neurosurgery, published online, ahead of print, April 10, 2020. https://thejns.org/doi/abs/10.3171/2020.3.JNS20929

Cenzato M, DiMeco F, Fontanella M, Locatelli D, Servadei F: Editorial. Neurosurgery in the storm of COVID-19: suggestions from Lombardy region, Italy (ex malo bonum). Journal of Neurosurgery, published online, ahead of print, April 10, 2020. https://thejns.org/doi/abs/10.3171/2020.3.JNS20960

Wellons JC III, Grant G, Krieger MD, Ragheb J, Robinson S, Weprin B, Ojemann J: Editorial. Early lessons in the management of COVID-19 for the pediatric neurosurgical community from the leadership of the American Society of Pediatric Neurosurgeons. Journal of Neurosurgery: Pediatrics, published online, ahead of print, April 10, 2020. https://thejns.org/doi/abs/10.3171/2020.3.PEDS20215

The COVID-19 pandemic has wreaked havoc in the lives of people across the world. The numbers of cases and deaths from the disease continue to climb at a rapid pace. Many deaths have occurred among health care workers. On both a personal and professional level, the JNSPG editors acknowledge, with sadness, the passing of fellow neurosurgeon Dr. James T. Goodrich, Chief of Pediatric Neurosurgery, Montefiore Medical Center, New York City, from complications related to COVID-19 on March 30.

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For 76 years, the Journal of Neurosurgery has been recognized by neurosurgeons and other medical specialists the world over for its authoritative clinical articles, cutting-edge laboratory research papers, renowned case reports, expert technical notes, and more. The Journal of Neurosurgery: Pediatrics focuses on diseases and disorders of the central nervous system and spine in children. This journal contains a variety of articles, including descriptions of preclinical and clinical research as well as case reports and technical notes. Both peer-reviewed journals are published monthly by the JNS Publishing Group, the scholarly journal division of the American Association of Neurological Surgeons. Other peer-reviewed journals published by the JNS Publishing Group include Neurosurgical Focus, Neurosurgical Focus: Video, and the Journal of Neurosurgery: Spine. All five journals can be accessed at www.thejns.org.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 10,000 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, and peripheral nerves. For more information, visit www.AANS.org.