Screw-Lock: A Novel Technique to Secure Burr Hole Base Ring in DBS Surgery

NeedDuring deep brain stimulation (DBS) surgery, the base ring of the burr hole is the main structure that anchors the DBS lead. A discrepancy between the burr hole size and ring base renders the ring unstable which in turn compromises lead stability. Burr hole size mismatch is often seen in resource-poor countries where advanced perforators, that make exact size holes are not available.Technical SolutionWe describe a simple, cost-effective technique, the screw-lock method. When there is a mismatch, titanium self-tapping screws are inserted through the holding holes of the base ring into the skull with immediate and stable fixation.Proof of ConceptThis technique not only immediately secures the base ring to the skull but also prevents accidental displacement of the DBS lead.Next StepsThe titanium screws can be included in the burr hole ring set in commercially available products. A new type of expandable burr hole rings can be designed to fit any size of burr hole.ConclusionThis is an effective method to stabilize the burr hole base ring and the DBS lead.