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Simultaneous bilateral stereotactic procedure for deep brain stimulation implants: a significant step for reducing

Erich Talamoni Fonoff1,2, Angelo Azevedo1, Jairo Silva Dos Angelos1

  • 1Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, University of São Paulo Medical School; and.

Journal of Neurosurgery
|December 20, 2015
PubMed
Summary

Simultaneous bilateral deep brain stimulation (DBS) implantation significantly reduces surgical time by 38.5% compared to sequential methods. This approach offers comparable clinical outcomes for Parkinson

Keywords:
DBS = deep brain stimulationGPi = globus pallidus internusPD = Parkinson's diseaseParkinson diseaseSTN = subthalamic nucleusUPDRS-III = Unified Parkinson's Disease Rating Scale Part IIIVim = ventralis intermedius nucleusbrain shiftdeep brain stimulationfunctional neurosurgerymicroelectrode recordingmovement disorders

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Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Technology

Background:

  • Bilateral deep brain stimulation (DBS) procedures traditionally involve sequential implantation of leads in each hemisphere.
  • Optimizing surgical efficiency in bilateral DBS is crucial for patient care and resource management.

Purpose of the Study:

  • To evaluate the feasibility and clinical outcomes of simultaneous bilateral DBS lead implantation.
  • To compare the surgical operating time between simultaneous and sequential bilateral DBS procedures.

Main Methods:

  • A comparative study involving 57 patients with movement disorders undergoing bilateral DBS implantation.
  • Patients were randomly assigned to either traditional sequential implantation (28 patients) or simultaneous bilateral implantation (29 patients).
  • Clinical outcomes, specifically the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) scores and medication dosages, were compared 1 year post-surgery.

Main Results:

  • Simultaneous bilateral DBS implantation reduced total operating time by 38.51% (136.4 minutes) compared to the sequential approach (220.3 minutes).
  • Both methods yielded comparable improvements in UPDRS-III scores (approximately 47.8%) for Parkinson's disease patients after 1 year.
  • Reductions in levodopa-equivalent doses were similar between the simultaneous and sequential groups.

Conclusions:

  • Simultaneous bilateral DBS implantation is a feasible approach that significantly decreases surgical operating time.
  • This technique optimizes functional stereotactic procedures by reducing microrecording time without compromising clinical efficacy.
  • The simultaneous method offers a more efficient alternative for bilateral DBS surgeries.