The Role of the Pediatric Neurosurgeon in the International Forum

Abstract

Introduction The recent emphasis on surgery as an essential yet neglected component of global health care has drawn attention to the lack of pediatric neurosurgery in LMICs. Most LMICs have very few neurosurgeons able or willing to care for children, leaving few access to care for readily treatable conditions, like pediatric hydrocephalus and spina bifida. Herein, we review the role of pediatric neurosurgeons to improve hydrocephalus management and medical education in LMICs.

Methods A literature search on global pediatric neurosurgery was performed using the Pubmed database from the year 2000 to present.  

Results The majority of current pediatric neurosurgical efforts focus on the management of hydrocephalus. ETV ± CPC has emerged as an effective alternative to VP shunting for CSF diversion in LMICs. Neurosurgical programs in LMICs are most successful when twinning is used to pair the program with an established center in a HIC. Multiple international pediatric neurosurgical efforts aim to provide medical expertise, infrastructure, and surgical education to LMICs. The next step in developing sustainable surgery programs in LMICs includes establishing local training programs.

Conclusion Existing global pediatric neurosurgery programs are most successful when partnered to an experienced center in a HIC. A lack of funding, resources, and training programs all pose barriers to increasing the pediatric neurosurgical capacity in LMICs. Future global neurosurgery efforts may look to other neurosurgical conditions with high burdens of diseased in LMICs, like epilepsy.