Neurosurgical procedures pattern in Ayder Comprehensive Specialized Referral Hospital

Background Understanding the pattern of procedures has significant impute in understanding the pitfalls so that corrective measures will be implemented to improve the service. Some of the pitfalls studied as bottle neck in neurosurgery service provision are luck of advanced surgical technique, poor perioperative management, and communication issues. Objectives This study aims to assess the patterns of neurosurgical procedures performed at Ayder Comprehensive Specialized Referral Hospital in Tigray, Ethiopia, from March 2018 to August 2021. Methods A descriptive study was conducted at Ayder Comprehensive Specialized Referral Hospital, Tigray's only specialized neurosurgical facility. Data were collected from operation registration books and individual patient records, including patient demographics (age and sex), mode of operation, pre-operative diagnosis, and the type of procedure performed (emergency and elective). Data were analyzed using SPSS, and results were summarized using frequency tables and percentages. Results A total of 3,003 neurosurgical procedures were performed between March 2018 and August 2021. Of the total surgeries, more than 82.7% (2482) were males; pediatrics (16 years old) was 25.7%, while adults (16-59 years old) were 45.5%. Over the three-year period, the highest number of surgeries was recorded in 2019, comprising 42.3% of the total. In contrast, the lowest number recorded in 2018 was 18.32%. Of the total surgical cases, 56% were due to head injuries, followed by neural tube defects (9.8%), chronic subdural cases (9%), and spinal cord injuries (4%). Regarding procedures performed, 42.5% of the cases were treated by elevation surgery, followed by craniotomy (18.7%). Neuroendoscopic surgery and minimally invasive surgeries constituted only a small proportion, with aneurysm clipping performed in just 0.1% of cases. No endoscopic third ventriculostomy (ETV), seizure surgery, or minimally invasive spine surgery procedures were performed during the study period. Conclusions The findings indicate the dominance of trauma-related neurosurgical cases, particularly among younger populations. The data underscore the urgent need for targeted public health interventions to prevent traumatic brain injuries and improve maternal health to address congenital conditions. Continued investment in neurosurgical services and preventive measures is essential for improving patient outcomes in Tigray. To minimize referral and death from lack of advanced skill, Investment in manpower training in advanced spirality and equipping with advanced technology are key.