Therapeutic

Deep Brain Stimulation (DBS)
DBS is an invasive medical procedure in which electrodes are implanted deep within the brain and connected to an implantable pulse generator (IPG), typically placed in the chest. DBS can be “open-loop,” delivering continuous stimulation, or “closed-loop” (also called responsive or adaptive DBS), where the device records neuronal signals and adjusts stimulation based on specific brain activity patterns. DBS is approved for conditions like Parkinson’s disease, essential tremor, dystonia, epilepsy, and OCD. It is also being explored for various neurological and psychiatric conditions, including depression and substance use disorders.

Transcranial Magnetic Stimulation (TMS)
TMS is a non-invasive procedure that uses a magnetic coil placed over the head to deliver electrical pulses to the brain. These pulses generate a magnetic field that passes through the skull, stimulating or inhibiting specific brain areas to affect brain function. TMS is used to treat neurological and psychiatric disorders, such as depression.

Spinal Cord Stimulation (SCS)
SCS involves placing a device in the spinal canal, just above the spinal cord. Like DBS, it is connected to an IPG and can operate in both open-loop and closed-loop modes. SCS is primarily used to treat chronic pain by altering pain signals before they reach the brain. It is also being investigated for movement restoration following stroke or spinal cord injury.

Low Intensity Focused Ultrasound (LIFU)
Focused ultrasound (FUS) is a non-invasive therapeutic technology that uses sound waves to target tissue deep within the brain or body without incisions or radiation. High-intensity focused ultrasound (HIFU) is used to create precise lesions by heating small areas of pathological brain tissue, and it is currently indicated for essential tremor and tremor-dominant Parkinson’s disease. LIFU, on the other hand, uses lower energy to modulate or excite small areas of the brain or body without causing damage. LIFU is an exciting area of research for non-invasive neuromodulation of the central and peripheral nervous systems.

Peripheral and Cranial Nerve Stimulation
Vagal Nerve Stimulation (VNS): VNS involves stimulating the vagus nerve, which extends from the brain down the neck to the heart, lungs, and digestive system. Implantable VNS is FDA-approved for epilepsy and depression, while non-invasive VNS devices are being explored for various other indications.

Hypoglossal Nerve Stimulation (HNS): HNS is an approved treatment for obstructive sleep apnea. Like closed-loop DBS or SCS, it involves stimulating the hypoglossal nerve to move the tongue forward and open the airway during specific phases of breathing.

Sacral Nerve Stimulation (SNS): SNS is an implantable device where a small IPG is placed in the buttocks and connected to the sacral nerves in the lower back. Electrical impulses sent to the sacral nerve improve bladder and bowel function.

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Spinal Orthopedic Procedures
Spinal fusion surgery is a procedure that permanently joins two or more vertebrae in the spine to correct curvature, stabilize the spine, and prevent further progression. This surgery often uses various implanted devices to hold the vertebrae in place while they fuse. There is a risk of nerve or spinal cord injury during the procedure, so neurodiagnostic tools or intraoperative neuromonitoring services are frequently used to mitigate this risk.

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Joint Orthopedic Procedures
Joint arthroplasty, also known as joint replacement, is a surgical procedure that replaces a damaged joint with a prosthetic one. The goal is to relieve pain from osteoarthritis and restore joint function. During total shoulder or hip arthroplasty, nerve injuries—while rare—are a serious potential complication. Nerve monitoring techniques may be employed to reduce this risk.

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Endovascular Procedures
Neuroendovascular procedures, also known as neurointerventional radiology, use a minimally invasive approach used to treat strokes, brain aneurysms, arteriovenous malformations (AVMs), and brain tumors. These procedures involve accessing the patient’s vascular system through a small incision in the groin, eliminating the need for open brain surgery and significantly reducing recovery time. Various devices, such as stents, coils, cages, flow diverters, and mechanical retrievers, are used during neuroendovascular treatments.