Martin K Daniel, Polanski Witold, Schackert Gabriele, Sobottka Stephan B
Department of Neurosurgery, University Hospital Carl-Gustav-Carus, Technical University of Dresden, Dresden, Germany.
Department of Neurosurgery, University Hospital Carl-Gustav-Carus, Technical University of Dresden, Dresden, Germany.
World Neurosurg. 2015 Dec;84(6):2037-42. doi: 10.1016/j.wneu.2015.06.074. Epub 2015 Jul 9.
A drop foot occurs in up to 20% of stroke patients and leads to an increased risk of falls. Until recently, only a foot orthosis or surface stimulation was able to improve the gait of these patients. Recent studies have shown that direct peroneal nerve stimulation with an implantable 4-channel peroneal nerve stimulator (ActiGait) allows independent electrode adjustment and leads to better functional results and an improved quality of life. The application of this therapeutic option is restricted to patients with a drop foot attributable to a lesion of the first motor neuron caused by stroke, multiple sclerosis, or tumors. In this paper, we present the first technical note with possible pitfalls of the surgical procedure and the perioperative care after implantation of ActiGait drop foot stimulators in 50 patients.
足下垂在高达20%的中风患者中出现,并导致跌倒风险增加。直到最近,只有足部矫形器或表面刺激能够改善这些患者的步态。最近的研究表明,使用可植入的4通道腓总神经刺激器(ActiGait)进行直接腓总神经刺激可实现独立电极调整,并带来更好的功能结果和生活质量改善。这种治疗选择的应用仅限于因中风、多发性硬化症或肿瘤导致第一运动神经元损伤而引起足下垂的患者。在本文中,我们介绍了首例技术说明,内容包括在50例患者中植入ActiGait足下垂刺激器的手术过程可能存在的陷阱以及围手术期护理。