Neurosurgery in Costa Rica: historical evolution and contemporary state

Background The development of neurosurgery in Central America has been shaped by the gradual expansion of public healthcare systems, academic medical training, and international collaboration. Costa Rica represents a distinctive case within Latin America due to its universal healthcare model and centralized hospital network. This study aims to describe the origins, institutional development, and contemporary status of neurosurgery in Costa Rica within the broader context of Latin American neurosurgical history. Methods This is a historical and descriptive narrative review, not a systematic review; no protocol was registered. Sources included institutional reports and archives from the Caja Costarricense de Seguro Social and the University of Costa Rica, national and international public-health statistics, English- and Spanish-language peer-reviewed literature, and biographical and historiographic material. Results The emergence of neurosurgery in Costa Rica occurred during the mid-twentieth century alongside the expansion of the national public healthcare system. Early neurosurgical procedures were initially performed by general surgeons until the return of internationally trained physicians established dedicated neurosurgical services. During the 1960s and 1970s, neurosurgical departments were established in the country's principal tertiary hospitals. Today, approximately 54 neurosurgeons provide care to a population of over five million inhabitants through a centralized national referral network. Modern practice incorporates advanced technologies such as neuronavigation and intraoperative neuromonitoring. Nevertheless, challenges persist, including workforce limitations, growing demand for neurosurgical care, and the absence of domestic subspecialty training programs and academic output. Conclusion The history of neurosurgery in Costa Rica illustrates how specialized surgical disciplines can emerge within a small but highly organized healthcare system through academic development and international collaboration. Continued investment in training, infrastructure, and global partnerships will be essential to address current challenges and support the future growth of neurosurgery in the country.