Elective neurosurgical humanitarian care in a deployed setting

Area of Science:

• Neurosurgery
• Military Medicine
• Global Health

Background:

• Active-duty neurosurgical coverage has been provided at Bagram Air Force Base, Afghanistan, since 2007.
• Initially focused on battlefield injuries, the caseload shifted towards elective neurosurgical humanitarian care (NHC) before 2015.
• A debate exists on whether the benefits of NHC outweigh its costs in a deployed military setting.

Purpose of the Study:

• To evaluate the safety and efficacy of elective neurosurgical humanitarian care (NHC) provided in a deployed military setting.
• To analyze the types of neurosurgical procedures performed and patient outcomes during a specific deployment period.
• To inform the ongoing discussion regarding the value of NHC in military operational contexts.

Main Methods:

• Retrospective review of a personal database of neurosurgical procedures performed at Bagram Air Force Base from April to October 2014.
• Exclusion of nonelective surgical care for battlefield injuries.
• Extraction of clinical and radiological data for all elective NHC cases.

Main Results:

• A total of 49 patients received elective NHC, with procedures including spinal degenerative disease (n=28), cranial tumors (n=11), and pediatric conditions (n=6).
• Follow-up ranged from 3 to 23 weeks, with a low complication rate including one hardware revision, one wound infection, and one residual tumor resection.
• No instances of postoperative neurological decline were observed.

Conclusions:

• Elective neurosurgical humanitarian care (NHC) can be safely and effectively implemented in deployed environments.
• NHC strengthens relationships between military forces, local populations, and enhances neurosurgical team skills.
• The study supports the continuation of NHC strategies in military deployments.