Brooks Arrin, Hoyt Alastair T
Department of Biomedical Research, Marshall University, Joan C Edwards School of Medicine, Huntington, WV 25701, USA.
Department of Neurosurgery, Joan C Edwards School of Medicine, Huntington, WV 25701, USA.
Brain Sci. 2021 May 3;11(5):592. doi: 10.3390/brainsci11050592.
With more than two decades of experience and thousands of patients treated worldwide, deep brain stimulation (DBS) has established itself as an efficacious and common surgical treatment for movement disorders. However, a substantial majority of patients in the United States still undergo multiple, "staged" surgeries to implant a DBS system. Despite several reports suggesting no significant difference in complications or efficacy between staged and non-staged approaches, the continued use of staging implies surgeons harbor continued reservations about placing all portions of a system during the index procedure. In an effort to eliminate multiple surgeries and simplify patient care, DBS implantations at our institution have been routinely performed in a single surgery over the past four years. Patients who underwent placement of new DBS systems at our institution from January 2016 to June 2019 were identified and their records were reviewed. Revision surgeries were excluded. Total operative time, length of stay and rates of surgical site infections, lead fracture or migration, and other complications were evaluated. This series expands the body of evidence suggesting placement of a complete DBS system during a single procedure appears to be an efficacious and well-tolerated option.
凭借二十多年的经验以及在全球治疗了数千名患者，脑深部电刺激术（DBS）已成为一种治疗运动障碍的有效且常用的外科手术。然而，美国绝大多数患者仍需接受多次“分期”手术来植入DBS系统。尽管有几份报告表明分期手术和非分期手术在并发症或疗效方面没有显著差异，但分期手术的持续使用意味着外科医生对在初次手术中放置系统的所有部分仍持保留态度。为了消除多次手术并简化患者护理，在过去四年中，我们机构的DBS植入手术常规在一次手术中完成。确定了2016年1月至2019年6月在我们机构接受新DBS系统植入的患者，并对他们的记录进行了审查。排除翻修手术。评估总手术时间、住院时间以及手术部位感染、导线断裂或移位以及其他并发症的发生率。该系列研究扩展了证据，表明在单一手术过程中放置完整的DBS系统似乎是一种有效且耐受性良好的选择。
