Estimates suggest that 53.7% of neurological procedures performed in the US are essential procedures, while 46.3% are elective. Procedures that are deemed essential are often related to serious traumas or tumors and can be life-threatening to the patient if not performed immediately. The American Association of Neurological Surgeons and American College of Surgeons recommended that essential neurological procedures are to be performed as soon as possible. However, safety measures should be taken to protect the patients and medical staff from COVID-19, GlobalData, a leading data and analytics company.

Eric Chapman, Medical Devices Analyst at GlobalData, says: “Essential procedures include injection of anesthetic into the peripheral nerve for analgesia, insertion of catheters into the spinal canal for infusion of therapeutic substances, excision or destruction of a lesion or tissue of the brain, insertion or replacement of external ventricular drains (EVD), incision of cerebral meninges, and repair of spinal cord structures.”  

Chapman continues: “Of the 46.3% of procedures that are elective, the top ten procedures account for 96.9% of the total volume and include spinal taps, exploration and decompression of the spinal canal, video and radio-telemetered electroencephalographic monitoring, injection of agents into the spinal canal, and other non-operative neurologic function tests. These procedures can be delayed”.

In general, trans-sphenoidal surgeries (surgery of the brain through the nose) should be avoided unless proper PPE is available, or done through a transcranial approach (through the head or skull). Using the ACS and CMS triaging guidelines grading surgeries, elective spine surgeries have been given a tier 2 rating and should be postponed if possible. Other neurosurgical procedures, in general, have a tier 3 rating, meaning that healthcare professionals should conduct procedures immediately, assuming resources are available.

Chapman concludes: “Given the critical nature of neurological procedures, GlobalData predicts that elective procedure volumes will return to pre-COVID-19 levels by Q4 2020, following a decline of new COVID-19 cases to a manageable level, likely to be below 2.5 cases per 100,000.”