Introduction: The novel coronavirus disease 2019 (COVID-19) became an important and urgent threat to global health. In Slovenia, the COVID-19 struck the health system immensely. Neurosurgery experienced difficulties, not only in regular, elective surgeries, but also during emergency situations. Methods: In the article, we analyse and compare the number of elective and emergency neurosurgical procedures during the time of the pandemic (from March 2018 to February 2020) and describe our protocol in the management of neurosurgical patients in the Medical Centre in Ljubljana, Slovenia. Results: There were 2597 patients treated surgically, including 1932 emergency patients and 665 emergency patients. Overall, we recorded an 11.2% drop in all neurosurgical procedures in two years after COVID-19 was declared compared to two years before. Elective procedures decreased by 13.9%, mostly on account of spinal pathology procedures (245, 23.5%), functional neurosurgical procedures (37 cases, 24.7%), endonasal endoscopy procedures (11, 12.8%), and brain lesions (31, 4.8%). Conclusion: COVID-19 had a vast impact on the healthcare system in Slovenia, including on neurosurgery. New and improved strategies to maintain neurosurgical practice during public health emergencies are necessary for the neurosurgical service and healthcare system to run smoothly in the long term and prevent disruptions during future pandemics.

The novel coronavirus disease 2019 (COVID-19) is an ongoing disease caused by severe acute respiratory syndrome coronavirus-2 that still poses an important and urgent threat to global health. In Slovenia, the epidemic was declared on March 12 th , 2020, and since then COVID-19 has had a great impact on our health system. The field of neurosurgery in particular has been experiencing difficulties in both elective and emergency service. In this article, we described epidemiologic protocols and the effect that the COVID-19 pandemic had on the surgical practice and workflow of the Department of Neurosurgery at the University Medical Centre Ljubljana. We analyzed and compared the number of elective and emergency neurosurgical procedures in a 2-year period before and during the pandemic. We recorded a drop in cases mostly on account of elective procedures whilst emergency service remained relatively unaffected.