A simple stereotactic method for frameless deep brain stimulation.

Abstract:

BACKGROUND:Deep brain stimulation (DBS) is widely used to treat advanced Parkinson's disease, other movement and psychiatric disorders. DBS implantation requires application of a stereotactic frame throughout a lengthy procedure, making it uncomfortable and tiring. We designed a stereotactic cube to stage the operation, perform frameless microelectrode recording (MER) and fix the DBS. METHODS:The 15-mm cube is implanted in a burr hole using bone cement. It contains 5 parallel trajectories (central + 4 around). It is aligned by stereotactic frame so that central trajectory reaches the target. Frameless MER is performed by attaching a micro-driver to the cube using 2-5 cannulae (4 cm). The DBS is fixed to the cube by a mini-plate and 1 screw. Ninety-six cubes were compared with 43 Bennet spheres (BS). RESULTS:No cube moved compared to 2 (5%) BS (p < 0.05). The final trajectory was central in 64.4% of cubes compared to 47.5% of BS, and the final target was >2 mm out in no cubes compared to 12.5% of BS (p < 0.01). Infection and haemorrhage were observed in 2.5% and 3.3% of cubes, respectively, while 5% of BS developed infection, 5% haemorrhage and 7.5% skin erosion. CONCLUSIONS:This method is simple and effective in staging DBS procedures, performing frameless MER and DBS implantation, fixation and revision.

authors

Eljamel MS,Tulley M,Spillane K

doi

10.1159/000096633

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

6-10

issue

1

eissn

1011-6125

issn

1423-0372

pii

96633

journal_volume

85

pub_type

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