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一种用于将电极连接器固定在颅骨上的凹槽技术:疗效案例分析

A groove technique for securing an electrode connector on the cranial bone: case analysis of efficacy.

作者信息

Lee Sung-Woo, Lee Myung-Ki, Seo Il, Kim Ho-Sang, Kim Jeong-Ho, Kim Yun-Suk

机构信息

Department of Neurosurgery, Maryknoll Hospital, Busan, Korea.

出版信息

J Korean Neurosurg Soc. 2014 Aug;56(2):130-4. doi: 10.3340/jkns.2014.56.2.130. Epub 2014 Aug 31.

Abstract

OBJECTIVE

A groove technique for securing an electrode connector was described as an alternative surgical technique in deep brain stimulation (DBS) surgery to avoid electrode connector-related complications, such as skin erosion, infection, and migration.

METHODS

We retrospectively reviewed 109 patients undergoing one of two techniques; the standard technique (52 patients using 104 electrodes) and the groove technique (57 patients using 109 electrodes) for securing the electrode connector in DBS surgery, regardless of patient disease. In the standard percutaneous tunneling technique, the connector was placed on the vertex of the cranial surface. The other technique, so called the groove technique, created a groove (about 4 cm long, 8 mm wide) in the cranial bone at the posterior parietal area. Wound erosion and migration related to the connectors were compared between the two techniques.

RESULTS

The mean follow-up period was 73 months for the standard method and 46 months for the groove technique. Connector-related complications were observed in three patients with the groove technique and in seven patients with the standard technique. Wound erosion at the connector sites per electrode was one (0.9%) with the groove technique and six (5.8%) with the standard technique. This difference was statistically significant. The electrode connector was migrated in two patients with the groove technique and in one patient with the standard technique.

CONCLUSIONS

The groove technique, which involves securing an electrode using a groove in the cranial bone at the posterior parietal area, offers an effective and safe method to avoid electrode connector-related complications during DBS surgery.

摘要

目的

一种用于固定电极连接器的凹槽技术被描述为深部脑刺激(DBS)手术中的一种替代手术技术,以避免与电极连接器相关的并发症,如皮肤糜烂、感染和移位。

方法

我们回顾性分析了109例行两种技术之一的患者;标准技术(52例患者使用104根电极)和凹槽技术(57例患者使用109根电极),用于在DBS手术中固定电极连接器,不考虑患者疾病。在标准经皮隧道技术中,连接器置于颅顶表面。另一种技术,即所谓的凹槽技术,是在顶叶后部区域的颅骨上创建一个凹槽(约4厘米长,8毫米宽)。比较两种技术中与连接器相关的伤口糜烂和移位情况。

结果

标准方法的平均随访期为73个月,凹槽技术为46个月。凹槽技术组有3例患者和标准技术组有7例患者出现与连接器相关的并发症。凹槽技术中每个电极连接器部位的伤口糜烂为1例(0.9%),标准技术为6例(5.8%)。这种差异具有统计学意义。凹槽技术组有2例患者电极连接器移位,标准技术组有1例患者电极连接器移位。

结论

凹槽技术,即在顶叶后部区域的颅骨上使用凹槽固定电极,为避免DBS手术中与电极连接器相关的并发症提供了一种有效且安全的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad76/4200360/8ed0ad9a65ad/jkns-56-130-g001.jpg

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