# Use of technologies in neurosurgery – a national survey of the section “techniques and innovations”

## TL;DR

This study surveys the use of advanced technologies in German neurosurgery, finding that academic hospitals lead in equipment and training but gaps remain in broader implementation.

## Contribution

A national survey in Germany reveals disparities in the adoption and education of modern neurosurgical technologies across hospital types.

## Key findings

- University hospitals have more advanced equipment and higher surgical volumes compared to other centers.
- Intraoperative neuromonitoring and neuronavigation are widely available but inconsistently implemented.
- Residency programs in university hospitals offer more training in innovative techniques.

## Abstract

Advancements in neurosurgery have transformed the field, enabling safer, minimally invasive procedures supported by modern navigation, neuromonitoring, and intraoperative imaging techniques. The integration of robotics and navigation systems further enhances surgical precision, while advanced imaging modalities like intraoperative MRI and CT scans allow real-time visualization, facilitating more accurate tumor removal and hardware placement. Emerging technologies such as virtual reality and augmented reality are revolutionizing surgical planning, education, and patient-specific modeling. Despite these innovations, the application and education regarding these tools remain limited. This study aims to provide a comprehensive report on the availability of advanced techniques and facilities, as well as the quality of education imparted in Germany. To address this, a nationwide survey was conducted among 89 departments to evaluate the availability and utilization of modern neurosurgical technologies. The survey revealed that university hospitals tend to possess more advanced equipment, perform higher surgical volumes, and offer 24/7 services more frequently than other centers. Techniques such as intraoperative neuromonitoring, neuronavigation, and advanced imaging are widely available, particularly in academic centers; however, gaps exist in their consistent implementation across all hospitals. Residency programs increasingly incorporate training in these innovative techniques, with a strong correlation between university hospital status and educational opportunities. The survey highlights the need for broader dissemination of these technologies and standardized training to ensure all centers can provide high-quality, around-the-clock neurosurgical care. Overall, ongoing research, technological integration, and education are vital for advancing neurosurgical outcomes and expanding access to cutting-edge treatments across Germany.