Decorative neurosurgery refers to:

A style of neurosurgical practice or publication that prioritizes visual sophistication, technical complexity, or aesthetic appeal over clinical necessity, patient outcomes, or evidence-based justification.

• Use of high-tech tools (e.g., exoscopes, 3D navigation, tubular retractors) without improving outcomes
• Focus on surgical choreography over therapeutic value
• Emphasis on “how” it’s done rather than “why” it should be done
• Extrapolation of techniques from one pathology to another without justification (e.g., applying glioma strategies to metastases)

“Supramarginal resection of a well-circumscribed brain metastasis in an eloquent area is not oncological rigor — it’s decorative neurosurgery.”

• Lack of outcome data (survival, function, recurrence)
• Absence of discussion on alternative therapies (e.g. radiosurgery)
• Focus on intraoperative images, toolkits, and “novel” corridors
• No acknowledgment of risks, costs, or patient selection criteria

• clinical elegance
• academic theater
• marketing pamphlet

Synonyms: surgical vanity, aesthetic neurosurgery, technological maximalism

Opposite: Purposeful, evidence-based, outcome-driven surgery.