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Electrode Fixation with Bone Cement or Stimloc® in Deep Brain Stimulation Surgery: A Comparative Study
Onder Taskin1, Ersoy Kocabicak, Sait Ozturk
1Ministry of Health, Carsamba Government Hospital, Neurosurgery Clinic, Samsun, Turkey.
Turkish Neurosurgery
|February 11, 2022
Summary
Stimloc® fixation is faster than bone cement for subthalamic nucleus deep brain stimulation in Parkinson's disease patients. Both methods show similar clinical outcomes and complication rates, but Stimloc® offers improved patient comfort.
Area of Science:
- Neurosurgery
- Neurology
- Biomedical Engineering
Background:
- Subthalamic nucleus deep brain stimulation (STN-DBS) is a key treatment for Parkinson's disease (PD).
- Effective electrode fixation is crucial for STN-DBS success and patient outcomes.
- Comparing fixation techniques like bone cement and Stimloc® is essential for optimizing surgical procedures.
Purpose of the Study:
- To compare the postoperative outcomes of electrode fixation using bone cement versus Stimloc® in STN-DBS for Parkinson's disease.
- To evaluate differences in surgery duration, electrode migration, and clinical effectiveness between the two fixation methods.
Main Methods:
- A comparative study involving 30 Parkinson's disease patients undergoing STN-DBS, with 15 patients receiving bone cement and 15 receiving Stimloc® for electrode fixation.
- Preoperative and 1-year postoperative assessment of Unified Parkinson's Disease Rating Scale (UPDRS) III scores and levodopa equivalent daily dose (LEDD).
- Postoperative evaluation using brain CT for pneumocephalus, hematoma, and electrode migration at 1 year.
Main Results:
- Stimloc® fixation demonstrated a significantly shorter application time (6 minutes) compared to bone cement (21 minutes).
- Electrode migration after 1 year was minimal and comparable between groups (0.92 mm for bone cement, 0.88 mm for Stimloc®).
- No significant differences were found in infection rates, pneumocephalus volume, wound erosion, or clinical outcomes between the two fixation techniques.
Conclusions:
- Stimloc® is advantageous due to its shorter application duration, enhancing patient comfort during awake surgery.
- Both bone cement and Stimloc® offer similar clinical efficacy and complication profiles for STN-DBS electrode fixation.
- Stimloc® may be preferred for its efficiency and patient tolerance in STN-DBS procedures.
