Background: The informed consent process in neurosurgery aims to support patient autonomy and provide comprehensive information for decision-making. However, gaps in communication and understanding between patients and surgeons persist, that need to be addressed. This systematic review examined the interventions and strategies which to enhance the process of consent in neurosurgery.

Methods: A comprehensive search of databases and relevant sources to identify relevant studies for inclusion. Systematic review of prospective and retrospective studies that assess the effect of interventions which improve the consent process. Data collection and analysis involved independent reviewers assessing eligibility, study quality, and risk of bias. Findings from the included studies were used to write the review.

Main results: The reviewed identified seven studies notably revealed an educational and interactive consent process involving strategies like booklets, videos, multiple interviews, and interactive websites showed improvements in patient knowledge. Recall of risks decreased over time, and factors like age, education, and timing of consent influenced recall.

Authors’ conclusions: To maximise informed consent, neurosurgeons should consider various strategies. Tailoring communication-based on patient's health literacy and treatment knowledge, involving their support system, and using a bullet-point consent form is essential. Utilising multiple modalities like verbal, static, and dynamic visuals improve information retention. Creative and memorable visual aids enhance comprehension. Allowing time for questions and team approach is superior.

Keywords: GMC guidelines; Informed consent; litigations; malpractice; negligence; neurosurgery; spine.

背景： 神经外科中的知情同意过程旨在支持患者的自主权，并为决策提供全面的信息。然而，患者与医生之间的沟通和理解仍然存在差距，这些问题需要得到解决。这项系统综述研究了提高神经外科知情同意流程的各种干预措施和策略。

方法： 对数据库及相关来源进行全面搜索，以识别相关研究供纳入。系统性回顾前瞻性及回顾性的研究，这些研究评估了能够改善知情同意过程的干预效果。数据收集与分析包括独立评审员评估合格性、研究质量和偏倚风险。所包含的研究结果用于撰写综述。

主要结果： 综述中发现了七项相关研究，这些研究表明教育性和互动性的知情同意过程（如使用手册、视频、多次访谈和互动网站等策略）可以改善患者的知识水平。风险记忆随时间的推移而减少，并且诸如年龄、教育程度以及同意的时间等因素会影响记忆力。

作者结论： 为了最大程度地提高知情同意的效果，神经外科医生应考虑多种策略。根据患者的健康素养和治疗知识来调整沟通方式，纳入支持系统，使用要点形式的同意书至关重要。利用多种形式（如口头、静态和动态视觉材料）可以改善信息保留率。创意且易记的视觉辅助工具能够增强理解力。留出时间让患者提问，并采用团队合作的方法更为优越。

关键词： GMC指南；知情同意；诉讼；医疗过失；疏忽；神经外科；脊柱。