Securing dual ipsilateral leads through a single burr hole in deep brain stimulation surgery: technical note

Area of Science:

• Neurosurgery
• Neurological Devices
• Surgical Techniques

Background:

• Deep brain stimulation (DBS) typically uses a single lead per burr hole.
• Placing dual ipsilateral leads through one burr hole is rare but necessary for specific indications.
• Existing literature lacks technical guidance on securing dual ipsilateral DBS leads.

Purpose of the Study:

• To describe a novel, safe, and effective method for placing and securing two ipsilateral DBS leads through a single burr hole.
• To address the technical challenge of dual lead fixation in DBS surgery.
• To provide a reproducible technique for neurosurgeons.

Main Methods:

• Utilized standard cranial plating equipment.
• Modified a burr hole-mounted anchoring ring for dual lead fixation.
• Described the step-by-step procedure for placing and securing two leads ipsilaterally via a single burr hole.
• Applied the technique in a cohort of six patients.

Main Results:

• Successfully implanted and secured two ipsilateral DBS leads through a single burr hole in all six patients.
• No detectable displacement of the first lead occurred during the second lead's implantation.
• The described method proved safe and effective in the patient cohort.

Conclusions:

• The described technique provides a reliable method for dual ipsilateral DBS lead placement and fixation.
• This approach overcomes previous technical limitations for rare DBS indications.
• The method ensures stable lead positioning, crucial for effective neuromodulation.