Robaina Padrón F J
Unidad del Dolor Crónico y Neurocirugía Funcional, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria.
Neurocirugia (Astur). 2008 Apr;19(2):143-55. doi: 10.4321/s1130-14732008000200006.
Surgical neuromodulation refers to all those techniques that use implantable devices that discharge electricity or chemical substances that modify nerve signal transmission in order to achieve inhibition, excitation or modulation of the activity of neuronal groups and networks, and to achieve a therapeutic effect. Neuromodulation encompasses different scientific aspects and technologies which need to be defined.
From the surgical point of view, neuromodulation is defined as: those intervention techniques that alter the transmission of neuronal signals using implantable electrical or chemical devices with the objective of stimulating, inhibiting or modulating the activity of neurones or neuronal networks to achieve therapeutic effects. A clinical definition makes reference to the use of reversible electrical or chemical stimulation of the nervous system to manipulate its activity in order to treat some specific types of chronic pain and conditions such as spasticity, epilepsy, cardiac ischemia, alterations in the motility of the intestine and of the bladder, lesions of the nervous system, and alterations in mobility, visual, auditory or psychiatric status. Neurosurgeons have been well trained to perform a great number of surgical techniques of neuromodulation, even including helping to significantly increase biomedical activities and the application of high technology to the central and peripheral nervous system.
Surgical neuromodulation encourages the neurosurgeon to go also away from the classical techniques of surgical resection and neuroablative procedures, and to enter into the new field of neuroengineering to re-establish lost neurological functions. The inter-relationship between the brain and the computer (brain-machine interface) has already occurred and has been applied in the field of neuroprosthetics and deep brain stimulation. For neurosurgery in general and for Spain in particular, this represents a new opportunity to embark on a high technology path that would involve years of research but, applying these new, non-invasive surgical techniques would help resolve the neurological problems of many of our patients.
手术神经调节是指所有使用可植入装置的技术，这些装置释放电或化学物质来改变神经信号传递，以实现对神经元群和神经网络活动的抑制、兴奋或调节，并达到治疗效果。神经调节涵盖了需要定义的不同科学方面和技术。
从手术角度来看，神经调节被定义为：那些使用可植入的电或化学装置改变神经元信号传递的干预技术，目的是刺激、抑制或调节神经元或神经网络的活动以达到治疗效果。临床定义涉及使用对神经系统的可逆电刺激或化学刺激来操纵其活动，以治疗某些特定类型的慢性疼痛和病症，如痉挛、癫痫、心脏缺血、肠道和膀胱运动障碍、神经系统损伤以及运动、视觉、听觉或精神状态改变。神经外科医生已接受良好培训，能够执行大量神经调节手术技术，甚至包括帮助显著增加生物医学活动以及将高科技应用于中枢和周围神经系统。
手术神经调节促使神经外科医生也远离传统的手术切除和神经毁损手术技术，进入神经工程新领域以重建丧失的神经功能。大脑与计算机之间的相互关系（脑机接口）已经出现并已应用于神经假体和深部脑刺激领域。对于一般的神经外科手术，特别是对于西班牙而言，这代表了一个踏上高科技道路的新机会，这将涉及多年的研究，但是应用这些新的非侵入性手术技术将有助于解决我们许多患者的神经问题。
