The clinical practice of reconstructive neurosurgery

Surgical interventions to improve function following nervous system injury have been in development since the early 1900s. Only recently these have been assimilated into a coherent approach which can be applied to injuries of the brain, spinal cord and peripheral nerves. In addition to pharmacological and stimulation based interventions, surgical manipulation of the peripheral nerves and muscles of the extremity can offer functional enhancement for a variety of limb impairments. In order to plan an effective surgical intervention, neurophysiological assessment of the injury and residual motor control is essential. Effective implementation of these surgical interventions can enhance function and quality of life for many individuals whose activity has been limited as a result of nervous system injury.