This book on spinal restabilization techniques is an anatomical, biomechanical, clinical, radiological, and surgical overview of the diagnostic methods and newest treatment options for use in patients presenting with degenerative disc disease associated with spinal instability. Edited by a Neurosurgeon and a Neuroradiologist with extensive experience in these areas, it covers the most current information in the field of modern spinal corrective surgery. The varied therapeutic options are presented by many of the primary inventors and first users of the wide array of newly developed and individually unique intersegmental stabilization devices, interbody disc fusion appliances and intervertebral disc replacement implants. This international collection of chapters is intended to be of interest not only to spine surgeons, but also to any physician involved in the diagnosis and treatment of degenerative disc disease and spinal instability that is resistant to conservative management.

In the rapidly-evolving landscape of neurosciences, it is no easy task to select a limited array of topics to present in a text such as this. The current volume takes as its purpose to provide a representative survey of the current science of brain repair for those seeking to establish a foundation in the field or to replenish a prior knowledge base that may have lapsed in its currency. It also hopes to offer insights into what remains elusive to our collective investigations, defining the frontiers of brain repair for those that are currently immersed in the exciting intersection of biological advances and neuroscientific discoveries.

In Chapter 1 the fundamentals of imaging transplanted cells is discussed with emphasis on animal models as well as the horizon for clinical trials. Then, detailed methods on the culture of neural stem cells is reviewed as a foundation for approaching therapeutic goals. Chapter 3 presents the broad scope of animal models that serve as the foundation for developmental and pre-clinical investigation, with mention of recent genetically engineered mouse models that represent the best models for studying disease development and treatment. Chapter 4 provides background on the delivery techniques to animals and patients that are available, providing vital information on the subtleties of technique necessary for optimal cellular grafting. Chapters 5 and 6 discuss new and evolving information on the origins of brain tumors and the indelible role of stromal and microenvironmental influences on oncogenesis and tumor progression. Subsequently, the utility of neural stem cells as cellular vehicles to deliver chemotherapeutics to broad neuropathology is reviewed. In Chapter 8 the scope of treating brain tumors is expanded beyond stem cells, to present the best biological interventions to improve upon current treatment options for brain malignancy. The last two chapters present a comprehensive review on stem cell and gene therapy options for treating cerebrovascular and neurovascular pathology.

In amassing this collection, my intention has been to provide the reader with a broad introduction into molecular imaging, stem cell biology, cell therapy, animal models, central nervous system malignancies, stroke, and neurodegeneration. My hope is that Frontiers of Brain Repair will be the intellectual soil from which a deeply rooted and well-nourished vintage of neuroscience will arise."

Agreed standards and guidelines are the heart and soul of improving the differing training systems and to harmonize neurosurgical training in the European countries. Such standards and guidelines have been laid down in the European Training Charter of the European Union of Medical Specialists and recently novellated. This book, written by experienced neurosurgeons, offers all those concerned with neurosurgical training - trainers and trainees - practical advice to implement the above mentioned standards and recommendations. It has been written as a manual: "How to do it". It describes the tasks of a chairman (programme director), the tasks of the teaching staff, the organisation of a training curriculum, a rotation plan or a morbidity and mortality conference, the periodic progress evaluation, the course of an external audit and many more important topics. It contains a lot of practical tips, check lists and useful examples. Well educated young colleagues offer "safe neurosurgery" to our patients.

Most people think that stroke victims end up looking like Frankenstein with a horrible facial expression and erratic movements. But, that is not the way it has to be. Today, it is possible for some stroke victims to make a full recovery. Gerry Purdy knows this because his wife, Alicia - a healthy, beautiful and smart person - suffered a stroke on August 23, 2011 and was able to return to her vivacious self. Our Stroke of Luck portrays the life they had together. Gerry and Alicia had dated in high school and got back together for their 45th high school reunion. Life was good. And then - Bam! - without warning Alicia suffered a stroke. Find out how Alicia's neurosurgeon was able to remove the clot from her brain that caused the stroke. Experience the tense ups and downs of that night-one moment seeming as though she might be paralyzed on her left side for the rest of her life and then the next seeing a flash of hope. Gerry and Alicia were lucky that the radiologist was able to identify the clot in her brain and lucky to get her transferred to the Marcus Stroke Center at Grady Hospital in Atlanta. They were lucky that Dr. Nogueira was able to extract the clot from Alicia's brain. And, finally, they were lucky that she was able to make a full recovery. Truly, this was their stroke of luck.

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series of Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. This series was first discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathers of the series being Jean Brihaye, Bernard Pertuiset, Fritz Loew and Hugo KrayenbtihI. Thus were established the principles of European co operation which have been born from the European spirit, flourished in the European Association, and have throughout been associated with this series. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publi cation of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume.

Emotions, behaviors, thoughts, creations, planning, daily physical activities, and routines are programmed within our brains. To acquire these capacities, the brain takes time to fully develop--a process that may take the first 20 years of life. Disruptions of the brain involving neurons, axons, dendrites, synapses, neurotransmitters or brain infrastructure produce profound changes in development and functions of the one organ that makes us unique. To understand the functions and development of the brain is difficult enough, but to reverse the consequences of trauma and repair the damage is even more challenging. To meet this challenge and increase understanding, a host of disciplines working and communicating together are required.
The International Association for the Study of Traumatic Brain Injury tried to correct this limitation during its meetings of international clinicians, researchers, and scientists from many fields. It was felt that many of the outstanding thoughts and ideas from the participants' most recent meeting and from others working in the field of traumatic brain injury (TBI) should be shared. This book was conceived not as proceedings of the conference, but as a collection of knowledge for those working in the acute and chronic recovery aspects of head injury.
This book reflects the importance of the team approach to patients with TBI. The chapter authors come from a diverse array of disciplines--basic science, neurosurgery, neurology, radiology, psychology, neuropsychology, and legal, consumer, and speech/language science. Their contributions provide the most current research and the latest ways of managing a variety of aspects of TBI.

Emotions, behaviors, thoughts, creations, planning, daily physical activities, and routines are programmed within our brains. To acquire these capacities, the brain takes time to fully develop--a process that may take the first 20 years of life. Disruptions of the brain involving neurons, axons, dendrites, synapses, neurotransmitters or brain infrastructure produce profound changes in development and functions of the one organ that makes us unique. To understand the functions and development of the brain is difficult enough, but to reverse the consequences of trauma and repair the damage is even more challenging. To meet this challenge and increase understanding, a host of disciplines working and communicating together are required.
The International Association for the Study of Traumatic Brain Injury tried to correct this limitation during its meetings of international clinicians, researchers, and scientists from many fields. It was felt that many of the outstanding thoughts and ideas from the participants' most recent meeting and from others working in the field of traumatic brain injury (TBI) should be shared. This book was conceived not as proceedings of the conference, but as a collection of knowledge for those working in the acute and chronic recovery aspects of head injury.
This book reflects the importance of the team approach to patients with TBI. The chapter authors come from a diverse array of disciplines--basic science, neurosurgery, neurology, radiology, psychology, neuropsychology, and legal, consumer, and speech/language science. Their contributions provide the most current research and the latest ways of managing a variety of aspects of TBI.

Most individuals with brain damage experience a curtailment or loss of lifestyle without rehabilitation. Improved methods and appropriately timed medical interventions now make it possible for more individuals to survive brain insults and to be assisted by rehabilitation neuropsychologists in achieving renewed commitment to life. Damage to the brain -- the organ of human emotions and cognition -- reduces psychological functioning and realistic adaptation, and the patient and his/her family are often encapsulated in the time prior to injury. To regain part or most of the lifestyle lost, an honest, dedicated, and realistic approach is required. Neuropsychological rehabilitation can provide tools for this task, provided that the most comprehensive, elaborate and knowledge-based methods are integrated in the training, and provided that knowledge from many disciplines and from community environments and family is encompassed.
In the present book knowledge representing the development of neuropsychological rehabilitation during the past five years is collected from a conference titled "Progress in Neuropsychological Rehabilitation." The chapters are written by professionals who were invited to share their experiences from different areas within the field because of their expertise with processes involved in neuropsychological rehabilitation. After a historical review, the chapters follow a visible sequence from biology to neuropsychology and neuropharmacology. Experts discuss the most advanced medical knowledge of the effect of injury on states of the organism. The second part of the book is dedicated to the outcome and the economics of rehabilitation as well as plans for the future. Finally, a panel discussion addresses the overall concept: Is rehabilitation worthwhile and ethical? The reactions -- influenced by the cross-cultural exchange of knowledge -- shed light on the essence and practice of today's neurorehabilitation.

Surviving Neurosurgery: Vignettes of Resilience is a practical guide to the inner workings of the lives of neurosurgeons, healthcare partners, and patients. To this end, this text serves as a first-hand documentary of the unique challenges faced as one progresses through their career. It is a snapshot in time capturing the experiences of both patients and providers. The text is divided into seven parts that run the gamut of a neurosurgeon's career symbolic of the seven years of neurosurgical training. These narratives include, but are not limited to, residency challenges, surgical nuances, research and funding, embracing humanity, patient experiences, and overcoming hurdles along the journey. Chapters share the wisdom and experiences of over 100 authors consisting of patients, trainees, advanced practice providers, and attending neurosurgeons.

Detecting residual cognitive function in disorders of consciousness (M. R. COLEMAN, J. D. PICKARD).- Rationale for hypothalamus-deep brain stimulation in food intake disorders and obesity (N. TORRES, S. CHABARDEES, A. L. BENABID).- Gustatory and reward brain circuits in the control of food intake (A. J. OLIVEIRA-MAIA, C. D. ROBERTS, S. A. SIMON, M. A. L. NICOLELIS).- SEEG-guided RF-thermocoagulation of epileptic foci: A therapeutic alternative for drug-resistant non-operable partial epilepsies (M. GU NOT, J. ISNARD, H. CATENOIX, F. MAUGUIERE, M. SINDOU).- Child abuse some aspects for neurosurgeons (B. MADEA, M. NOEKER, I. FRANKE.- Prophylactic antibiotics and anticonvulsants in neurosurgery (B. RATILAL, C. SAMPAIO).- The dural sheath of the optic nerve: descriptive anatomy and surgical applications (P. FRANCOIS, E. LESCANNE, S. VELUT) -Surgical indications and techniques for failed coiled aneurysms (C. RAFTOPOULOS; with the collaboration of G. VAZ).

Advances
J. Maarrawi, P. Mertens, R. Peyron, L. Garcia-Larrea, M. Sindou: Functional exploration for neuropathic pain. - Z. H. Rappaport: The neuroscientific foundations of free will. - A. Hejcl, P. Jendelova, E. Sykova: Experimental reconstruction of the injured spinal cord. - M. Visocchi: Advances in video-assisted anterior surgical approach to the craniovertebral junction.
Technical Standards
N. Akalan: Myelomeningocele (Open spina bifida): Surgical management. - M. Stoffel, C. St er, F. Ringel, B. Meyer: Treatment of infections of the spine. - I. Massimi, F. Novegno, C. di Rocco: Chiari Type 1 malformation in children.

This practical handbook allows nurses, advanced practice nurses, physician assistants, and allied health professionals practicing in the fields of neurosurgery, neurology, and spinal care to quickly review essentials while in the work environment. It emphasizes procedural steps and critical elements in patient management, including intensive care, the neurological examination, differential diagnoses, and pain management. Written by a multidisciplinary team of experts, the handbook is expected to become a well-worn companion and essential aid to the busy practitioner.

This new edition reflects the explosion of knowledge in basic science and clinical care for athletes with mild traumatic brain injury or concussion. Interest in management and methodology for making diagnoses and improving the clinical outcomes have changed dramatically. All U.S. states have laws dictating how sports concussion patients are cared for and require return to play decisions be coordinated with best practice methods. Epidemiology, classification, and biology of sports concussion, as well as, brain imaging,assessment tests, neuropsychological measures, and management strategies are covered. Illustrative clinical cases, correlative examples, and historical insights are featured.

This practical handbook allows nurses, advanced practice nurses, physician assistants, and allied health professionals practicing in the fields of neurosurgery, neurology, and spinal care to quickly review essentials while in the work environment. It emphasizes procedural steps and critical elements in patient management, including intensive care, the neurological examination, differential diagnoses, and pain management. Written by a multidisciplinary team of experts, the handbook is expected to become a well-worn companion and essential aid to the busy practitioner.

Preoperative Events switches the focus from post-operative rehabilitation to preoperative experiences and personal histories to lessen the consequences of brain damage. These papers document the relationship between preoperative experience and postoperative performance and discuss a variety of protective preoperative experiences that can ameliorate the deleterious effects of brain damage.

Preoperative Events switches the focus from post-operative rehabilitation to preoperative experiences and personal histories to lessen the consequences of brain damage. These papers document the relationship between preoperative experience and postoperative performance and discuss a variety of protective preoperative experiences that can ameliorate the deleterious effects of brain damage.

Widely regarded as the definitive reference in the field, Youmans and Winn Neurological Surgery offers unparalleled, multimedia coverage of the entirety of this complex specialty. Fully updated to reflect recent advances in the basic and clinical neurosciences, the 8th Edition covers everything you need to know about functional and restorative neurosurgery, deep brain stimulation, stem cell biology, radiological and nuclear imaging, and neuro-oncology, as well as minimally invasive surgeries in spine and peripheral nerve surgery, and endoscopic and other approaches for cranial procedures and cerebrovascular diseases. In four comprehensive volumes, Dr. H. Richard Winn and his expert team of editors and authors provide updated content, a significantly expanded video library, and hundreds of new video lectures that help you master new procedures, new technologies, and essential anatomic knowledge in neurosurgery. Discusses current topics such as diffusion tensor imaging, brain and spine robotic surgery, augmented reality as an aid in neurosurgery, AI and big data in neurosurgery, and neuroimaging in stereotactic functional neurosurgery. 55 new chapters provide cutting-edge information on Surgical Anatomy of the Spine, Precision Medicine in Neurosurgery, The Geriatric Patient, Neuroanesthesia During Pregnancy, Laser Interstitial Thermal Therapy for Epilepsy, Fetal Surgery for Myelomeningocele, Rehabilitation of Acute Spinal Cord Injury, Surgical Considerations for Patients with Polytrauma, Endovascular Approaches to Intracranial Aneurysms, and much more. Hundreds of all-new video lectures clarify key concepts in techniques, cases, and surgical management and evaluation. Notable lecture videos include multiple videos on Thalamotomy for Focal Hand Dystonia and a video to accompany a new chapter on the Basic Science of Brain Metastases. An extensive video library contains stunning anatomy videos and videos demonstrating intraoperative procedures with more than 800 videos in all. Each clinical section contains chapters on technology specific to a clinical area. Each section contains a chapter providing an overview from experienced Section Editors, including a report on ongoing controversies within that subspecialty. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Advances and Technical Standards in Neurosurgery was conceived in 1972byitsfoundingfathersJeanBrihaye,BernardPertuiset,FritzLoew andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...2 8 Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke's Hospital,UniversityofCambridge,Cambridge,UK Abstract...61 Introduction...62 Surgicaltechnique...67 Cranialexposure...69 Cervicalexposure...70 Saphenousveinexposure...71 Preauriculartunnel...7 2 Contents IX Anastamoses...73 Distalanastamosis...73 Externalcarotidanastamosis...74 Closureandpostoperativecare...77 Discussion...77 Comparisonofoutcomes...77 Choosingthetypeofgraft...78 Longtermpatencyofgrafts...79 Ischaemiccomplications...79 Anticoagulationrelatedmorbidity...81 Conclusion...

Every year, an estimated 1.7 million Americans sustain brain injury. Long-term disabilities impact nearly half of moderate brain injury survivors and nearly 50,000 of these cases result in death. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma, including brain injury pathophysiology, biomarker research, experimental models of CNS injury, diagnostic methods, and neurotherapeutic interventions as well as neurorehabilitation strategies in the field of neurotraum research. The book includes several sections on neurotrauma mechanisms, biomarker discovery, neurocognitive/neurobehavioral deficits, and neurorehabilitation and treatment approaches. It also contains a section devoted to models of mild CNS injury, including blast and sport-related injuries. Over the last decade, the field of neurotrauma has witnessed significant advances, especially at the molecular, cellular, and behavioral levels. This progress is largely due to the introduction of novel techniques, as well as the development of new animal models of central nervous system (CNS) injury. This book, with its diverse coherent content, gives you insight into the diverse and heterogeneous aspects of CNS pathology and/or rehabilitation needs.

This is truly an exciting time in the field of neuro-oncology, particularly in the area of hi- grade gliomas. The management of patients with high-grade gliomas has historically been one of the most challenging and disheartening fields in medicine, where failure is the rule and longevity is the exception. The jaded often state that despite purported advances in surgical and radiotherapeutic techniques and a myriad of clinical trials of medical therapies, the s- vival statistics for glioblastoma have not changed in the last three decades. The nihilism associated with these tumors is such that some practitioners still advise against treatment or even biopsy, recommending palliative care with the diagnosis based only on history and an MRI scan. If the current state-of-the-art in the diagnosis and management of high-grade gliomas was truly so bleak, there would be no reason to compile and publish a monograph on the subject. The fact is that we have recently entered an era where real progress is being made in our understanding and treatment of high-grade gliomas that is directly benefiting some patients. We are slowly but surely chipping away at this problem. One approach has exploited correlations between particular molecular markers and therapeutic response. The first such "breakthrough" in high-grade glioma was the observation that loss of chromosomes 1p and 19q uniformly predict chemosensitivity in anaplastic oligodendrogliomas (1).

This book represents the first interdisciplinary text on the emerging field of rehabilitative surgery, in which state of the art procedures from multiple surgical specialties are combined. It proposes a completely new framework for understanding, coordinating, and providing treatment for paralyzed or severely neurologically impaired patients and explains the potentially critical impact of surgery in creating a new baseline of functional status, thereby improving the patient's daily life. Every major aspect of reconstructive surgical treatment is considered, including anesthesia, orthopedic surgery, plastic surgery, neurosurgery, general surgery, vascular surgery, and otolaryngology. The most up-to-date and evidence-based surgeries are clearly described and evaluated, with coverage of treatment of pressure sores, placement of feeding tubes, and upper extremity interventions to improve function and hygiene. Cutting-edge protocols are presented for the surgical treatment of severe nerve injuries, spinal cord injuries, and stroke or cerebrovascular accidents, and a first description and evaluation of phrenic nerve repair to assist weaning of paralyzed patients from ventilators is provided. Both surgical and nonsurgical readers will find this book to be an ideal guide and reference.

An easy to follow step-by-step guide to the most useful surgical skills from knot tying to simple procedures. Illustrated with colour photographs and video clips to demonstrate techniques, this book makes these practical skills as clear and easy to follow as possible. Including coverage of surgical instruments, wound management and suturing, and minor surgical procedures, it also explains how to use these essential surgical skills to make the most of a surgical placement. Healthcare students or junior professionals undertaking a placement in surgery or emergency medicine will feel confident and capable, and will be able to take an active role in surgical placements. Learning basic surgical skills is important for such placements, as well as for undertaking exams such as the Membership of the Royal College of Surgeons (MRCS).

Clinical neurophysiologic testing plays a critical role as a complement to the clinical assessment in patients who are being evaluated for a variety of neurologic symptoms. Many different techniques and methods of assessment can be used to evaluate the function of the nervous system, including electroencephalography, electromyography, evoked potentials, movement disorder studies, and sleep studies. An accurate understanding of the role of these tests and reliable technical performance and interpretation of these studies is critical in clinical practice. This new edition in the Contemporary Neurology Series remains an essential resource for physicians and technologists learning or utilizing clinical neurophysiology in their training or practice. This fifth edition updates the basic concepts underlying each of the techniques used in clinical neurophysiology and provides detailed descriptions of the methods, findings, studies, and value of the wide range of electrophysiologic testing available for patients with epilepsy and spells, neuromuscular diseases, movement disorders, demyelinating diseases, sleep disorders, autonomic disorders, and those undergoing orthopaedic and neurosurgical procedures in the operative setting. The role of each type of study, the interpretation of findings, and the application of the studies to different types of clinical problems are detailed throughout the text. It is a practical textbook for neurologists, physiatrists and clinical neurophysiologists in clinical or research practice or in training.

Implement TMR with Your Patients and Improve Their Quality of Life

Developed by Dr. Todd A. Kuiken and Dr. Gregory A. Dumanian, targeted muscle reinnervation (TMR) is a new approach to accessing motor control signals from peripheral nerves after amputation and providing sensory feedback to prosthesis users. This practical approach has many advantages over other neural-machine interfaces for the improved control of artificial limbs. Targeted Muscle Reinnervation: A Neural Interface for Artificial Limbs provides a template for the clinical implementation of TMR and a resource for further research in this new area of science.

After describing the basic scientific concepts and key principles underlying TMR, the book presents surgical approaches to transhumeral and shoulder disarticulation amputations. It explores the possible role of TMR in the prevention and treatment of end-neuromas and details the principles of rehabilitation, prosthetic fitting, and occupational therapy for TMR patients. The book also describes transfer sensation and discusses the surgical and functional outcomes of the first several TMR patients. It concludes with emerging research on using TMR to further improve the function and quality of life for people with limb loss.

With contributions from renowned leaders in the field, including Drs. Kuiken and Dumanian, this book is a useful guide to implementing TMR in patients with high-level upper limb amputations. It also supplies the foundation to enable improvements in TMR techniques and advances in prosthetic technology.