<p>Neuroprosthetics represents a dynamic field at the interface of neurosciences, engineering and neurosurgery that is based on implanted devices for restoration or extension of neurological functions. Important advances involve brain-computer and brain-spine interfaces that enable communication, motor and sensory feedback in paralyzed or anarthric patients. Intracortical arrays, subdural electrocorticographic lattices and endovascular electrodes provide different access routes, supplemented by strategies, such as spinal neuromodulation and functional electrostimulation. Recent studies confirmed the restoration of grasping movements, standing and walking as well as fluid speech and text communication, sometimes via avatars. Bidirectional systems with sensory feedback enhance the naturalness and precision. There are challenges in signal stability, longevity and minimally invasive access routes. With interdisciplinary cooperation and technical maturity neuroprostheses can enrich the routine neurosurgical care in the future.</p>