Guest Editor Commentary

摘要

Since the development of neurosurgery as a subspecialty of surgery about a century ago, 1 area that has received considerable attention is the problem of effective treatment of disorders of neuromuscular function. Earlier applications of neuro-surgical principles toward these diseases generally involve ablative therapies. Targets chosen for intervention were often based on autopsy evidence that correlated with neurologic deficits produced by previous stroke or trauma. However, technologic advances during the past decade have led to improved applications of older, established neurosurgical techniques. Such advances have also been responsible for the creation of novel methods for the neurosurgical management of movement disorders. Diseases such as Parkinson disease, essential tremor, spasticity, dystonia, and epilepsy can now be successfully treated in greater numbers than ever before. Movement disorders associated with multiple sclerosis, stroke, cerebral palsy, spinal cord injury, head injury, and others are managed much better today than a decade ago. Improvements in imaging techniques, precision target localization, and sophisticated electronic methods for functional mapping of the brain have provided the necessary tools for effectively treating these patients. The armamentarium of modern complex neurosurgical tools includes improved reference apparatus or frames, high resolution CT or MRI, and microelectrode recording and stimulation. Implantable devices for electronic signal or drug delivery to target tissues have also become invaluable weapons against movement disorders. Together with increased knowledge regarding patient selection and postoperative management, patient outcomes from the neurosurgical treatment of movement disorders have dramatically improved. The discipline of neurosurgery is advancing at a rapid rate, which will ultimately lead to even better methods to treat these common and debilitating clinical maladies.