Wang Tao, Pan Yixin, Zhang Chencheng, Zhan Shikun, Sun Bomin, Li Dianyou
Department of Functional Neurosurgery, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, 200025, China.
BMC Surg. 2019 Jul 15;19(1):92. doi: 10.1186/s12893-019-0558-9.
The accuracy of deep brain stimulation (DBS) depends on precise electrode positioning, which has been pursued for ideal treatment outcomes. As a critical component of DBS, the fixation performance of lead anchoring devices has been widely studied. Possible reasons for lead shift were analyzed in the current study and we further provided effective solutions to reduce potential manual errors.
Seventy-nine patients who received DBS implantations at the Ruijin Hospital from April to November 2017 were retrospectively reviewed. Intraoperative lead shifts were measured by C-arm fluoroscopy. Lead adjustment counts were recorded and compared among three lead fixation devices: Stimloc™ (Medtronic, Minneapolis, MN, USA), TouchLoc (SceneRay, Suzhou, China), and the traditional lead anchoring device.
Mean (± SD) distances of lead shifts were 0.29 ± 2.42 mm in Stimloc devices, 0.43 ± 0.55 mm in TouchLoc devices, and 1.52 ± 1.05 mm in traditional devices (p < 0.0001). Average numbers of adjustments in this series were 0.3 ± 0.5 in Stimloc devices, 0.3 ± 1.3 in TouchLoc devices, and 1.1 ± 1.0 in traditional devices (p = 0.0001). Pairwise comparisons among the three devices (TouchLoc vs. Stimloc: p = 0.273; TouchLoc vs. Traditional: p = 0.0001; Stimloc vs. traditional: p < 0.0001) suggested significant differences, which were mainly attributed to the traditional devices.
Three lead anchoring devices have been compared for their performance in the accuracy of lead fixation, in which the newly designed lead fixation devices have presented its advantages to the traditional one. In addition to the application of the Stimloc and TouchLoc devices, verification by C-arm fluoroscopy should be performed to provide an intuitive view of the depth deviation of electrode position during DBS electrode implantation.
脑深部电刺激术（DBS）的准确性取决于电极的精确放置，这一直是为了实现理想的治疗效果而追求的目标。作为DBS的一个关键组成部分，导线锚定装置的固定性能已得到广泛研究。本研究分析了导线移位的可能原因，并进一步提供了有效的解决方案以减少潜在的人为误差。
回顾性分析了2017年4月至11月在瑞金医院接受DBS植入手术的79例患者。术中通过C型臂荧光透视测量导线移位情况。记录并比较了三种导线固定装置（Stimloc™，美敦力公司，明尼阿波利斯，美国明尼苏达州；TouchLoc，苏州景昱医疗器械有限公司；以及传统导线锚定装置）的导线调整次数。
Stimloc装置中导线移位的平均（±标准差）距离为0.29±2.42毫米，TouchLoc装置中为0.43±0.55毫米，传统装置中为1.52±1.05毫米（p<0.0001）。本系列中，Stimloc装置的平均调整次数为0.3±0.5次，TouchLoc装置为0.3±1.3次，传统装置为1.1±1.0次（p=0.0001）。三种装置之间的两两比较（TouchLoc与Stimloc：p=0.273；TouchLoc与传统装置：p=0.0001；Stimloc与传统装置：p<0.0001）显示存在显著差异，主要归因于传统装置。
比较了三种导线锚定装置在导线固定准确性方面的性能，其中新设计的导线固定装置相对于传统装置具有优势。除了应用Stimloc和TouchLoc装置外，还应通过C型臂荧光透视进行验证，以直观呈现DBS电极植入过程中电极位置的深度偏差。
