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One for two? Exchanging implanted pulse generators for deep brain stimulation.

Zvi Israel1

  • 1Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel. israelz@hadassah.org.il

Neurosurgical Review
|July 5, 2005
PubMed
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Replacing expired single-channel deep brain stimulation generators with a dual-channel device involves clinical, practical, and financial considerations. We present a novel "one for two" surgical technique for this common IPG exchange scenario.

Area of Science:

  • Neurosurgery
  • Biomedical Engineering
  • Neuromodulation

Background:

  • Dual-channel implantable pulse generators (IPGs) are standard for new deep brain stimulation (DBS) procedures.
  • Battery depletion in bilateral single-channel IPGs necessitates generator replacement.
  • The decision to switch from two single-channel to one dual-channel IPG presents complex challenges.

Purpose of the Study:

  • To analyze the clinical, practical, and fiscal issues surrounding the exchange of bilateral single-channel IPGs for a single dual-channel IPG.
  • To introduce and describe a specific surgical technique for this IPG exchange.

Main Methods:

  • Review of clinical, practical, and fiscal considerations for IPG exchange.
  • Description of the "one for two" surgical technique for replacing two single-channel IPGs with one dual-channel IPG.

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Main Results:

  • The exchange of two single-channel IPGs for one dual-channel IPG involves significant clinical, practical, and fiscal debates.
  • The "one for two" technique offers a standardized approach to this IPG exchange.

Conclusions:

  • The decision to upgrade from single-channel to dual-channel IPGs requires careful consideration of multiple factors.
  • The described "one for two" technique provides a practical solution for IPG replacement in deep brain stimulation.