Neural interface technologies: applications of biomedical engineering to neurosurgery
The neurosurgical approach to diseases of the nervous system continues to evolve. As bioengineering technologies have advanced, an ally has been found to expand the role of the neurosurgeon in treating diseases not previously considered eligible for intervention. Not only are they purveyors of life-saving surgical treatments, but neurosurgeons have also embraced the application of new therapies for pain and disability, treating these as targeted disease entities in and of themselves. Consider the dramatic rise in implant technologies such as spinal pedicle screws and spinal cord stimulators to treat back pain, deep brain stimulators for functional disabilities, vagal nerve stimulators for epilepsy and depression, and peripheral nerve stimulators for pain and urinary incontinence. Sensory augmentation devices such as retinal prostheses and cochlear implant devices are in various stages of development by non-neurosurgeons and engineers. Technological developments have provided neuroscience-based clinicians with a venue to consider applications well beyond the purview of their predecessors. Many lessons can be gleaned from these and other “foreign” technologies, thereby accelerating the collaboration between the previously disparate disciplines of engineering and surgery and providing a venue for shared interests in the field of neural interface devices. In the future, leading neurosurgeons will continue to drive their craft forward by identifying the potential neurosurgical uses for emerging technology, directing engineering concepts toward surgical applications, and incorporating the technologies into daily practice.