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| {{Multiple issues| | | {{Short description|A surgical specialty focused on the restoration and enhancement of the nervous system's function and structure.}} |
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| {{Infobox medical intervention
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| | name = Neuroplastic surgery
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| '''Neuroplastic''' or '''neuroplastic and reconstructive surgery''' is the surgical specialty involved in reconstruction or restoration of patients who undergo surgery of the central or peripheral nervous system. The field includes a wide variety of surgical procedures that seek to restore or replace a patient’s skull, scalp, [[Meninges|dura]] (the protective covering of the brain and spinal cord), the spine and/or its overlying tissues.
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| == History of the field ==
| | '''Neuroplastic surgery''' is a specialized field within [[neurosurgery]] that focuses on the restoration, reconstruction, and enhancement of the [[nervous system]]'s function and structure. This field combines principles from [[plastic surgery]] and [[neuroscience]] to address both functional and aesthetic concerns related to the [[brain]], [[spinal cord]], and [[peripheral nerves]]. |
| Neuroplastic surgery has adapted reconstructive principles from the fields of [[craniofacial surgery]], and [[Plastic surgery|plastic and reconstructive surgery]] and refined them in order to address challenging deformities which result from Neurosurgical Procedures. The first center for Neuroplastic and Reconstructive Surgery was started at [[Johns Hopkins Hospital|Johns Hopkins University Hospital]] in Baltimore, Maryland by a formal collaboration between the Department of Plastic and Reconstructive Surgery, under the guidance of plastic surgeon Chad Gordon, and the Department of Neurosurgery under the guidance of neurosurgeon Judy Huang. Upon arrival to Johns Hopkins Hospital, Dr. Chad Gordon formed a multi-disciplinary team of physicians, scientists and engineers. The team’s unified goal was to develop techniques and devices to treat neurosurgical patients. These advances led to several publications and patents, and allowed for the establishment of the first formal fellowship training program in Neuroplastic and Reconstructive Surgery.<ref>Gordon CR, Huang J, Brem H. Neuroplastic Surgery. J Craniofac Surg. 2018 Jan;29(1):4-5. doi: 10.1097/SCS.0000000000004063. {{PMID|29077688}}.</ref><ref>Gordon CR. Understanding Cranioplasty. J Craniofac Surg. 2016 Jan;27(1):5.doi: 10.1097/SCS.0000000000002312. {{PMID|26716553}}. | |
| </ref><ref>Berli JU, Thomaier L, Zhong S, Huang J, Quinones A, Lim M, Weingart J, Brem H, Gordon CR. Immediate Single-Stage Cranioplasty Following Calvarial Resection for Benign and Malignant Skull Neoplasms Using Customized Craniofacial Implants. J Craniofac Surg. 2015 Jul;26(5):1456-62. doi: 10.1097/SCS.0000000000001816. {{PMID|26163837}}.</ref><ref>Gordon CR, Murphy RJ, Grant G, Armand M. Commentary on "A Multicenter Experience With Image-Guided Surgical Navigation: Broadening Clinical Indications in Complex Craniomaxillofacial Surgery". J Craniofac Surg. 2015 Jun;26(4):1140-2.doi: 10.1097/SCS.0000000000001673. {{PMID|26080144}}.</ref><ref>Murphy RJ, Wolfe KC, Liacouras PC, Grant GT, Gordon CR, Armand M.Computer-assisted single-stage cranioplasty. Conf Proc IEEE Eng Med Biol Soc.2015 Aug;2015:4910-3. doi: 10.1109/EMBC.2015.7319493. {{PMID|26737393}}.</ref><ref>Murphy RJ, Liacouras PC, Grant GT, Wolfe KC, Armand M, Gordon CR. A Craniomaxillofacial Surgical Assistance Workstation for Enhanced Single-Stage Reconstruction Using Patient-Specific Implants. J Craniofac Surg. 2016 Nov;27(8):2025-2030. doi: 10.1097/SCS.0000000000003106. {{PMID|28005747}}.</ref><ref name=":0">Zhong S, Huang GJ, Susarla SM, Swanson EW, Huang J, Gordon CR. Quantitative analysis of dual-purpose, patient-specific craniofacial implants for correction of temporal deformity. Neurosurgery. 2015 Jun;11 Suppl 2:220-9; discussion 229. doi: 10.1227/NEU.0000000000000679. {{PMID|25710104}}</ref><ref name=":1">Gordon CR, Yaremchuk MJ. Temporal augmentation with methyl methacrylate. Aesthet Surg J. 2011 Sep;31(7):827-33. doi: 10.1177/1090820X11417425. {{PMID|21908815}}.
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| </ref><ref>Ibrahim Z, Santiago GF, Huang J, Manson PN, Gordon CR. Algorithmic Approach to Overcome Scalp Deficiency in the Setting of Secondary Cranial Reconstruction. J Craniofac Surg. 2016 Jan;27(1):229-33. doi: 10.1097/SCS.0000000000002289. {{PMID|26703051}}.</ref><ref name=":2">Gordon CR, Santiago GF, Huang J, Bergey GK, Liu S, Armand M, Brem H, Anderson WS. First In-Human Experience With Complete Integration of Neuromodulation Device Within a Customized Cranial Implant. Oper Neurosurg (Hagerstown). 2017 Oct 6. doi: 10.1093/ons/opx210. [Epub ahead of print] {{PMID|29029236}}.</ref><ref>Gordon CR, Fisher M, Liauw J, Lina I, Puvanesarajah V, Susarla S, Coon A, Lim M, Quinones-Hinojosa A, Weingart J, Colby G, Olivi A, Huang J. Multidisciplinary approach for improved outcomes in secondary cranial reconstruction: introducing the pericranial-onlay cranioplasty technique. Neurosurgery. 2014 Jun;10 Suppl
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| 2:179-89; discussion 189-90. doi: 10.1227/NEU.0000000000000296. {{PMID|24448187}}; {{PMC|4703091}}.</ref> In March 2018, Dr. Gordon was appointed the Director of Neuroplastic and Reconstructive Surgery at Johns Hopkins.
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| The first peer reviewed journal to recognize neuroplastic and reconstructive surgery as its own field was the ''[[Journal of Craniofacial Surgery]]'' which dedicated its January 2018 issue to introducing the new field of neuroplastic surgery to its readership. In that issue, the editor-in-chief, Mutaz Habal, published an editorial on neuroplastic surgery where he stated: "Based on the desire to present the fact that neuroplastic surgery is there, we have a dedicated this issue of the ''Journal of Craniofacial Surgery''. This presentation mostly involves surgical procedures that will be termed ‘‘neuroplastic’’ in the years to come."<ref>Habal MB. Neuroplastic Surgery: The New Innovation in the Educational Process of Craniofacial Surgery. J Craniofac Surg. 2018 Jan;29(1):1-3. doi:
| | ==Overview== |
| 10.1097/SCS.0000000000004342. {{PMID|29283959}}.</ref>
| | Neuroplastic surgery aims to improve the quality of life for patients with neurological conditions by addressing both the functional deficits and the physical appearance resulting from [[neurological disorders]], [[trauma]], or [[surgical interventions]]. This approach is particularly important in cases where traditional neurosurgical techniques may not fully address the patient's needs. |
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| == Training == | | ==Techniques and Procedures== |
| Training in neuroplastic surgery requires completion of a neuroplastic and reconstructive surgery fellowship which lasts 1–2 years. Such fellowships are available to individuals who have completed a residency in P[[Plastic surgery|lastic and Reconstructive Surgery]], [[Otorhinolaryngology|ENT Surgery]], [[Neurosurgery]] or [[Oral and maxillofacial surgery|Oral and Maxillofacial surgery]]. As of today, the only formal fellowship training program in neuroplastic and reconstructive surgery is located at the [[Johns Hopkins School of Medicine]] and Johns Hopkins Hospital.<ref>{{Cite web|url=https://www.hopkinsmedicine.org/plastic_reconstructive_surgery/education/fellowships/neuroplastic_reconstructive_surgery_fellowship.html|title=Neuroplastic and Reconstructive Surgery Fellowship|last=|first=|date=|website=|access-date=February 21, 2018}}</ref> The fellowship is co-sponsored by both Departments of Plastic Surgery and Neurosurgery. The first surgeon formally trained in "Neuroplastic and Reconstructive Surgery" was Dr. Gabriel Santiago [2016-18], who completed [[Otorhinolaryngology|ENT surgery]] residency in the [[United States Navy|US Navy]] prior to starting the fellowship.{{citation needed|date=August 2018}} The first Neuroplastic Surgery Research Fellow was Dr. Amir Wolff [2017-18], an attending oral-maxillofacial surgeon from Rambam Medical Center in Haifa, Israel.{{citation needed|date=August 2018}}
| | Neuroplastic surgery employs a variety of techniques to achieve its goals. These include: |
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| == Neuroplastic surgery procedures ==
| | * '''Cranial Reconstruction''': This involves the repair and reconstruction of the [[skull]] following [[trauma]] or [[surgery]]. Techniques such as [[cranioplasty]] are used to restore the protective function and aesthetic appearance of the skull. |
| * [[Cranioplasty]] (or skull reconstruction) | |
| * Temporal Hollowing Repair <ref name=":0" /><ref name=":1" />
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| * Removal of Neurofibroma Tumors in [[Neurofibromatosis]]
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| * Complex Scalp Reconstruction
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| * Craniofacial Approaches to brain tumors
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| * Removal of skull and craniofacial tumors
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| * Complex Approaches to the spine and spinal cord
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| * Complex closures of the back following spine surgery
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| * Ventricular Shunt Revision
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| * Repair of [[Cerebrospinal fluid|Cerebrospinal Fluid]] (CSF) leaks
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| * Dural Reconstruction
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| * Implantation of Functional Neural Devices <ref name=":2" />
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| == References ==
| | * '''Peripheral Nerve Surgery''': This includes procedures to repair or reconstruct damaged [[peripheral nerves]], which can restore function and alleviate pain or [[neuropathy]]. |
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| {{reflist}}
| | * '''Functional Restoration''': Techniques such as [[nerve grafting]] and [[nerve transfer]] are used to restore function in cases of nerve injury or paralysis. |
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| | * '''Aesthetic Enhancement''': Neuroplastic surgery also addresses aesthetic concerns, such as the correction of [[facial asymmetry]] or deformities resulting from neurological conditions or surgeries. |
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| | ==Applications== |
| | Neuroplastic surgery is applied in various clinical scenarios, including: |
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| | * '''Traumatic Brain Injury (TBI)''': Reconstruction of the skull and restoration of neurological function following traumatic injuries. |
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| | * '''Congenital Anomalies''': Correction of congenital defects such as [[craniosynostosis]] or [[spina bifida]]. |
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| | * '''Tumor Resection''': Reconstruction following the removal of [[brain tumors]] to restore both function and appearance. |
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| | * '''Chronic Pain Management''': Surgical interventions to alleviate chronic pain conditions related to nerve damage. |
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| | ==Challenges and Future Directions== |
| | The field of neuroplastic surgery faces several challenges, including the complexity of the nervous system and the need for precise surgical techniques. Advances in [[imaging technology]], [[biomaterials]], and [[regenerative medicine]] are expected to enhance the capabilities of neuroplastic surgery in the future. |
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| | ==Related pages== |
| | * [[Neurosurgery]] |
| | * [[Plastic surgery]] |
| | * [[Cranial reconstruction]] |
| | * [[Peripheral nerve surgery]] |
| | * [[Functional neurosurgery]] |
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| | [[Category:Neurosurgery]] |
| [[Category:Plastic surgery]] | | [[Category:Plastic surgery]] |
| [[Category:Neurosurgery]] | | [[Category:Neuroplastic surgery]] |
| [[Category:Surgery]]
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| [[Category:Neurology]]
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| {{dictionary-stub1}}
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A surgical specialty focused on the restoration and enhancement of the nervous system's function and structure.
Neuroplastic surgery is a specialized field within neurosurgery that focuses on the restoration, reconstruction, and enhancement of the nervous system's function and structure. This field combines principles from plastic surgery and neuroscience to address both functional and aesthetic concerns related to the brain, spinal cord, and peripheral nerves.
Overview[edit]
Neuroplastic surgery aims to improve the quality of life for patients with neurological conditions by addressing both the functional deficits and the physical appearance resulting from neurological disorders, trauma, or surgical interventions. This approach is particularly important in cases where traditional neurosurgical techniques may not fully address the patient's needs.
Techniques and Procedures[edit]
Neuroplastic surgery employs a variety of techniques to achieve its goals. These include:
- Cranial Reconstruction: This involves the repair and reconstruction of the skull following trauma or surgery. Techniques such as cranioplasty are used to restore the protective function and aesthetic appearance of the skull.
- Peripheral Nerve Surgery: This includes procedures to repair or reconstruct damaged peripheral nerves, which can restore function and alleviate pain or neuropathy.
- Functional Restoration: Techniques such as nerve grafting and nerve transfer are used to restore function in cases of nerve injury or paralysis.
- Aesthetic Enhancement: Neuroplastic surgery also addresses aesthetic concerns, such as the correction of facial asymmetry or deformities resulting from neurological conditions or surgeries.
Applications[edit]
Neuroplastic surgery is applied in various clinical scenarios, including:
- Traumatic Brain Injury (TBI): Reconstruction of the skull and restoration of neurological function following traumatic injuries.
- Tumor Resection: Reconstruction following the removal of brain tumors to restore both function and appearance.
- Chronic Pain Management: Surgical interventions to alleviate chronic pain conditions related to nerve damage.
Challenges and Future Directions[edit]
The field of neuroplastic surgery faces several challenges, including the complexity of the nervous system and the need for precise surgical techniques. Advances in imaging technology, biomaterials, and regenerative medicine are expected to enhance the capabilities of neuroplastic surgery in the future.
Related pages[edit]
