Taskin Onder, Kocabicak Ersoy, Ozturk Sait, Yildiz Onur, Temel Yasin
Ministry of Health, Carsamba Government Hospital, Neurosurgery Clinic, Samsun, Turkey.
Turk Neurosurg. 2022;32(3):449-458. doi: 10.5137/1019-5149.JTN.35635-21.2.
To examine the postoperative outcomes of electrode fixation using bone cement and Stimloc® in patients with Parkinson?s disease (PD) who underwent subthalamic nucleus (STN) deep brain stimulation (DBS).
Between 2016 and 2018, permanent electrode fixation was performed in 30 patients with PD, of which 15 received bone cement and the remaining 15 received Stimloc®. Data regarding preoperative Unified Parkinson?s Disease Rating Scale (UPDRS) III scores, levodopa equivalent daily dose (LEDD) values, surgery duration, and the fixation technique used were recorded. Brain computed tomography was performed for early postoperative evaluation of pneumocephalus and possible hematoma as well as for the determination of migration 1 year postoperatively. UPDRS III scores and LEDD values were re-evaluated 1 year postoperatively; surgery duration, clinical effectiveness, and complication rates were compared between the two fixation techniques.
A statistically significant difference in application time was observed between the two techniques (bone cement: 21 min, Stimloc®: 6 min). After 1 year from surgery, 0.92- and 0.88-mm migrations were observed in the bone cement and Stimloc® groups, respectively. A significant correlation between migration and the pneumocephalus volume was observed in both groups. No differences were observed between the groups regarding infection, migration, pneumocephalus volume, wound erosion, and clinical outcomes.
Stimloc® is preferred over bone cement for electrode fixation in DBS surgeries as it is associated with shorter application duration; this increases patient comfort and tolerance during awake surgery. Clinical efficacy and complication rates associated with both techniques are similar.
研究在接受丘脑底核（STN）深部脑刺激（DBS）的帕金森病（PD）患者中，使用骨水泥和Stimloc®进行电极固定的术后结果。
2016年至2018年期间，对30例PD患者进行了永久性电极固定，其中15例接受骨水泥固定，其余15例接受Stimloc®固定。记录术前统一帕金森病评定量表（UPDRS）III评分、左旋多巴等效日剂量（LEDD）值、手术时间以及所使用的固定技术。术后早期进行脑部计算机断层扫描，以评估气颅和可能的血肿情况，并在术后1年确定电极移位情况。术后1年重新评估UPDRS III评分和LEDD值；比较两种固定技术的手术时间、临床疗效和并发症发生率。
观察到两种技术在应用时间上存在统计学显著差异（骨水泥：21分钟，Stimloc®：6分钟）。术后1年，骨水泥组和Stimloc®组分别观察到0.92毫米和0.88毫米的电极移位。两组中均观察到电极移位与气颅体积之间存在显著相关性。两组在感染、电极移位、气颅体积、伤口糜烂和临床结果方面未观察到差异。
在DBS手术中，Stimloc®比骨水泥更适合用于电极固定，因为它的应用时间更短；这提高了清醒手术期间患者的舒适度和耐受性。两种技术的临床疗效和并发症发生率相似。
