Neurorestorative interventions involving bioelectronic implants after spinal cord injury.
Cho NÉcole polytechnique fédérale de Lausanne (EPFL), Campus Biotech, Center for Neuroprosthetics and Brain Mind Institute, 1202 Genève, Switzerland.
Squair JWÉcole polytechnique fédérale de Lausanne (EPFL), Campus Biotech, Center for Neuroprosthetics and Brain Mind Institute, 1202 Genève, Switzerland.
Bloch J5Department of Neurosurgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
Courtine GÉcole polytechnique fédérale de Lausanne (EPFL), Campus Biotech, Center for Neuroprosthetics and Brain Mind Institute, 1202 Genève, Switzerland.
English
In the absence of approved treatments to repair damage to the central nervous system, the role of neurosurgeons after spinal cord injury (SCI) often remains confined to spinal cord decompression and vertebral fracture stabilization. However, recent advances in bioelectronic medicine are changing this landscape. Multiple neuromodulation therapies that target circuits located in the brain, midbrain, or spinal cord have been able to improve motor and autonomic functions. The spectrum of implantable brain-computer interface technologies is also expanding at a fast pace, and all these neurotechnologies are being progressively embedded within rehabilitation programs in order to augment plasticity of spared circuits and residual projections with training. Here, we summarize the impending arrival of bioelectronic medicine in the field of SCI. We also discuss the new role of functional neurosurgeons in neurorestorative interventional medicine, a new discipline at the intersection of neurosurgery, neuro-engineering, and neurorehabilitation.