What has been the most important advancement in neurosurgical practice over the last 10 years?

Neurosurgery is considered one of the oldest specialties, with evidence of surgical intervention being observed in skull specimens dating back to pre-history. Yet, the modern idea of neurosurgery is a very recent concept. Increasingly sophisticated technology has revolutionised the field, but arguably the greatest impact on patient outcomes has come from an only seemingly less exciting reform, which has transformed the structure of the service.   Over the last decade, efforts have been made to redefine the relationship between patients and healthcare practitioners, in favour of a more holistic and collaborative approach with the patient being placed at the centre of their own care. This shift has particularly impacted specialities like neurosurgery, where meticulous care planning frequently involves input from several other experts and healthcare professionals. Furthermore, advancements in the field of neurosurgery tend to stem from the process of optimisation of techniques, or tool kits, that were actually devised decades ago.   True paradigm shifts simply do not occur as frequently, and they are the result of new ways of understanding disease, or new ways of working. The work towards multidisciplinary approaches, patient centred care and social care constitutes the most significant advancement for patient outcomes and satisfaction in the field of neurosurgery over the last decade.