White-Dzuro Gabrielle A, Lake Wendell, Eli Ilyas M, Neimat Joseph S
Vanderbilt University School of Medicine, Nashville, Tenn., USA.
Stereotact Funct Neurosurg. 2016;94(1):18-23. doi: 10.1159/000442893. Epub 2016 Feb 17.
Fixation of the electrode during deep brain stimulation (DBS) surgery is an important aspect of the procedure. We have developed an alternative method for securing leads that utilizes a titanium hemoclip and cement. This technique is described, and the rates of complications are compared to conventional methods of securing leads.
A total of 291 DBS operations performed by a single surgeon were retrospectively analyzed. We reviewed medical records to look for complications. We compared rates of complications based on the technique used. Re sults: 9 patients (3.1%) developed surgical site infections (SSIs), 4 (1.3%) with SSI of the internal pulse generator pocket. Of the 5 SSIs around the leads, none occurred with StimLoc and 5 (1.1%) with the novel technique. Eight patients (2.7%) required surgical readjustment of the DBS leads due to suboptimal clinical benefit; all 8 (1.8%) occurred with the novel technique. Four patients (1.4%) had lead fractures, 2 (2.2%) with StimLoc and 2 (0.5%) with the novel technique.
We described a method for securing DBS leads and showed an acceptable incidence of hardware complications when compared to the conventional method. We feel this technique has improved cosmetic results and should be considered as a method for securing DBS leads.
在脑深部电刺激（DBS）手术中电极的固定是该手术的一个重要方面。我们开发了一种利用钛制血管夹和骨水泥固定导线的替代方法。本文描述了该技术，并将并发症发生率与传统的导线固定方法进行了比较。
对由一名外科医生进行的总共291例DBS手术进行回顾性分析。我们查阅病历以查找并发症。我们根据所使用的技术比较并发症发生率。结果：9例患者（3.1%）发生手术部位感染（SSI），4例（1.3%）发生内部脉冲发生器囊袋的SSI。在导线周围的5例SSI中，使用StimLoc的未发生，新技术组有5例（1.1%）。8例患者（2.7%）因临床获益不理想需要对DBS导线进行手术调整；所有8例（1.8%）均发生在新技术组。4例患者（1.4%）发生导线断裂，使用StimLoc的有2例（2.2%），新技术组有2例（0.5%）。
我们描述了一种固定DBS导线的方法，与传统方法相比，硬件并发症的发生率可以接受。我们认为该技术改善了美观效果，应被视为一种固定DBS导线的方法。
