Table 1.

Summary of included studies

StudyDigital tool evaluatedArea of applicationOutcomeLimitations
Alaraj et al, 20155Simulation/digital modelsEducation and preoperative planning3D anatomical details closely resembled real operative anatomy and were useful in guiding surgical approachesFew found the haptic feedback to closely resemble surgical procedures
Alsofy et al, 20206Simulation/digital modelsPre-operative planningImproved detection of aneurysm-related vascular structures and appropriate surgical approachesMay tempt surgeons to neglect a wider array of approaches
Ashkenazi et al, 20157TelemedicinePre-operative planningReduced number of institutional transfersNone described
Bairamian et al, 20198Simulation/digital modelsEducationVR angiography improved resolution, ease of manipulation, model durability and educational potentialPoorer depth perception
Breimer et al, 20179Simulation/digital modelsEducationRelative VR benefits with respect to realistic representation of intraventricular anatomyReduced overall instrument handling and procedural content
de Almeida et al, 202010Smartphone applicationsPerioperativeHigh accuracy and reliability of stereotactic brain biopsy coordinatesCertain features of interest are not available
de Notaris et al, 201111Simulation/digital modelsPre-operative planningImproved quantification of intraoperative bone removalTime consuming, not available intraoperatively, lack of depth perception
de Notaris et al, 201012Simulation/digital modelsPre-operative planningImproved quantification of intraoperative bone removalTime consuming, not available intraoperatively, lack of depth perception
Dong et al, 201813Simulation/digital modelsEducationHigh reported fidelity, high user satisfaction and perceived usefulnessNone described
Fan et al, 202014RoboticsPerioperativeSignificantly improved screw-placement accuracy, reduced operative blood loss and length of stayLearning curve required, unclear infection control protocol
Hou et al, 201615Smartphone applications and simulation/digital modelsPre-operative planningHigh accuracy in predicting basal ganglia haematoma locationNo error checking or location information during surgery
Latifi et al, 201816TelemedicinePre-operative planningDecreased need for institutional transferChallenges with initial cost, integration
Li et al, 201717Remote programmingPostoperative careSignificant decreases seen in UPDRS scoresNone described
Ma et al, 202118Remote programmingPostoperative careRapid symptom relief, institutional cost savingsLack of physical examination data
Macyszyn et al, 201319TelemedicineElectronic patient records and interdepartmental communicationCost savings through elimination of repeat imaging requestsIncreased operational complexity for departmental staff
Mandel et al, 201820Smartphone applicationsPerioperativeEnhanced surgical mobilityNone described
Mendez et al, 201321Remote programmingPostoperative careHigh levels of patient and clinician satisfactionNo benefit in accuracy of programming or rate of adverse events
Moya et al, 201022TelemedicinePre-operative planningDecrease in patient transfer requestsNone described
Olldashi et al, 201923TelemedicinePre-operative planningImproved access to care, decreased institutional transfer for low-risk patientsInitial set-up costs
Shibata, 201124TelemedicinePre-operative diagnosis/planningEarlier diagnosis of cerebral contusions, earlier escalation; improved planning time prior to emergency surgical interventionIncreased workload for consultant neurosurgeons
Stepan et al, 201725Simulation/digital modelsEducationIncreased engagement, motivation and satisfaction compared with conventional teachingNo improvement in clinical knowledge scores
Thapa et al, 201626Smartphone applicationsPre-/postoperative care, interdepartmental communication and educationReduced time taken to interpret clinical images, improved intra-team and interdisciplinary communicationSignificant discrepancies in image interpretation, greater risk of misuse of patient data
Wong et al, 200727Simulation/digital modelsEducation/pre-operative planningUsers gained a better understanding of the best approach for microsurgical clipping for the patientNone described
Xu et al, 202028Remote programmingPostoperative careSignificant improvement in UPDRS-III; 89.29% of patients were satisfied or very satisfiedReduced opportunity for physician-led physical examination to assess changes in muscle tone
Zappa et al, 201929RoboticsPerioperativeImproved completion times in bimanual tasks, decreased surgical fatigueResults indicated more difficulty and higher fatigue in simple grasping tasks
Zhang et al, 201930RoboticsPerioperativeIncreased accuracy of screw placement, decreased radiation doses, reduced rate of screw revisionsGreater learning curve, not necessarily more effective in completion of simple tasks, variable mental fatigue scores
  • UPDRS = Unified Parkinson's Disease Rating Scale; VR = virtual reality.