Operative neurosurgery (Hagerstown, Md.) · 2018
An Analysis of the Use of Multichannel Microelectrode Recording During Deep Brain Stimulation Surgeries at a Single Center.
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Falowski Steven, Dierkes James
Аннотация
BACKGROUND: Microelectrode recording (MER) can be used to map out the target nucleus and identify ideal lead placement.
OBJECTIVE: To assess the use of multichannel MER to increase the efficiency of lead placement without compromising patient safety.
METHODS: Analysis of a single center's technique for utilizing multichannel MER with 3 consistent anterior-to-posterior simultaneous passes that include an evaluation of the location of final lead placement, patient diagnosis, target nuclei, and additional work involved for refinement of targeting. Lead revision rates and rate of hemorrhage are also assessed.
RESULTS: There were a total of 237 lead placements in 123 patients over a 4-yr period. In 4.2% of lead placements, additional planning was required, while only 2.5% required additional MER. The lead placement matched 51.3% of the time in bilateral placements and was consistent regardless of target nuclei. In 84.8% of cases, the final lead placement was within the initial 3 MER passes. An additional 11.3% could be placed without the need for an additional pass. There were 2 lead revisions and no hemorrhage or stroke complications.
CONCLUSION: This series demonstrates that our technique of multichannel MER leads to accurate and efficient lead placement maintaining its safety profile.
OBJECTIVE: To assess the use of multichannel MER to increase the efficiency of lead placement without compromising patient safety.
METHODS: Analysis of a single center's technique for utilizing multichannel MER with 3 consistent anterior-to-posterior simultaneous passes that include an evaluation of the location of final lead placement, patient diagnosis, target nuclei, and additional work involved for refinement of targeting. Lead revision rates and rate of hemorrhage are also assessed.
RESULTS: There were a total of 237 lead placements in 123 patients over a 4-yr period. In 4.2% of lead placements, additional planning was required, while only 2.5% required additional MER. The lead placement matched 51.3% of the time in bilateral placements and was consistent regardless of target nuclei. In 84.8% of cases, the final lead placement was within the initial 3 MER passes. An additional 11.3% could be placed without the need for an additional pass. There were 2 lead revisions and no hemorrhage or stroke complications.
CONCLUSION: This series demonstrates that our technique of multichannel MER leads to accurate and efficient lead placement maintaining its safety profile.