Restorative neurosurgery: Opportunities for restoration of function in acquired, degenerative, and idiopathic neurological diseases

HISTORICALLY, NEUROSURGERY HAS improved the environment of the nervous syst em to promote maximal spontaneous recovery of function. The population of p atients whom we treat at present is a small portion of those who suffer fro m disabling neurological illnesses. Based on a combination of new technolog y, and advances in neuroscience, restorative neurosurgery is advancing the frontiers of our specialty, and providing the potential to restore lost fun ction. Significant advancements in gene therapy, the discovery and delivery of neurotrophic factors, and cell transplantation now require neurosurgeon s to broaden the scope of our practice so that it includes the restoration of function in an enormous number of patients with acquired, degenerative a nd idiopathic neurological diseases. In order to meet the present challenge , neurosurgeons must broaden our vision, our role, and our future education al goals. In this review, we summarize the landmark advances in the basic a nd clinical neurosciences and the results of clinical trials that are drivi ng our evolution from passive reaction to disease to active attempts to res tore lost central nervous system function.