The transformative power of telemedicine in delivering effective neurosurgical care in low and middle-income countries: A review.

Introduction: 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. Research Question: How has teleneurosurgery been used to enhance access to specialized neurological care and improve patient outcomes in low- and middle-income countries? Methods: 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study designs, including clinical trials, cohort studies, and case reports, were included, while isolated abstracts and unpublished studies were excluded.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. Results: 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. Discussion and Conclusion: 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.