Current Implantable Devices in Human Neurological Surgery

Abstract

The different nosological entities that lead to central nervous system (CNS) damage often produce neurological deficits that drastically impair the level of functional independence and quality of life of the individuals who suffer from them. Traditionally, neurosurgeons have played an important role in the acute phase of CNS lesions by carrying out different interventions aimed at their stabilization and the prevention of further progression. However, the constant appearance of new implantable devices offers new ways of treatment while providing novel strategies to induce plastic changes in the damaged circuits. On top of that, the new generations of neurosurgeons have on hand novel and more advanced cellular and sub-cellular tools that permit the manipulation of cells, molecules, and genes and the application of specific immunotherapy techniques in order to restore CNS morphology and function. The role of neurosurgery is, therefore, changing, and there is now an imminent need to redesign and develop less invasive, precise, and safe surgical interventions to apply these new therapies to a greater number of patients and at different stages of their diseases. This chapter reviews the main neurological devices for implantation in the CNS and the tools and methodologies used for their indication, diagnosis, and monitoring. Some concepts on deep brain stimulation and brain-machine interfaces are also discussed.