TY - JOUR
T1 - Simultaneous bilateral stereotactic procedure for deep brain stimulation implants
T2 - A significant step for reducing operation time
AU - Fonoff, Erich Talamoni
AU - Azevedo, Angelo
AU - Dos Angelos, Jairo Silva
AU - Martinez, Raquel Chacon Ruiz
AU - Navarro, Jessie
AU - Reis, Paul Rodrigo
AU - Sepulveda, Miguel Ernesto San Martin
AU - Cury, Rubens Gisbert
AU - Ghilardi, Maria Gabriela Dos Santos
AU - Teixeira, Manoel Jacobsen
AU - Lopez, William Omar Contreras
N1 - Publisher Copyright:
© AANS, 2016.
PY - 2016/7
Y1 - 2016/7
N2 - Objective Currently, bilateral procedures involve 2 sequential implants in each of the hemispheres. The present report demonstrates the feasibility of simultaneous bilateral procedures during the implantation of deep brain stimulation (DBS) leads. Methods Fifty-seven patients with movement disorders underwent bilateral DBS implantation in the same study period. The authors compared the time required for the surgical implantation of deep brain electrodes in 2 randomly assigned groups. One group of 28 patients underwent traditional sequential electrode implantation, and the other 29 patients underwent simultaneous bilateral implantation. Clinical outcomes of the patients with Parkinson's disease (PD) who had undergone DBS implantation of the subthalamic nucleus using either of the 2 techniques were compared. Results Overall, a reduction of 38.51% in total operating time for the simultaneous bilateral group (136.4 ± 20.93 minutes) as compared with that for the traditional consecutive approach (220.3 ± 27.58 minutes) was observed. Regarding clinical outcomes in the PD patients who underwent subthalamic nucleus DBS implantation, comparing the preoperative off-medication condition with the off-medication/on-stimulation condition 1 year after the surgery in both procedure groups, there was a mean 47.8% ± 9.5% improvement in the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score in the simultaneous group, while the sequential group experienced 47.5% ± 15.8% improvement (p = 0.96). Moreover, a marked reduction in the levodopa-equivalent dose from preoperatively to postoperatively was similar in these 2 groups. The simultaneous bilateral procedure presented major advantages over the traditional sequential approach, with a shorter total operating time. Conclusions A simultaneous stereotactic approach significantly reduces the operation time in bilateral DBS procedures, resulting in decreased microrecording time, contributing to the optimization of functional stereotactic procedures.
AB - Objective Currently, bilateral procedures involve 2 sequential implants in each of the hemispheres. The present report demonstrates the feasibility of simultaneous bilateral procedures during the implantation of deep brain stimulation (DBS) leads. Methods Fifty-seven patients with movement disorders underwent bilateral DBS implantation in the same study period. The authors compared the time required for the surgical implantation of deep brain electrodes in 2 randomly assigned groups. One group of 28 patients underwent traditional sequential electrode implantation, and the other 29 patients underwent simultaneous bilateral implantation. Clinical outcomes of the patients with Parkinson's disease (PD) who had undergone DBS implantation of the subthalamic nucleus using either of the 2 techniques were compared. Results Overall, a reduction of 38.51% in total operating time for the simultaneous bilateral group (136.4 ± 20.93 minutes) as compared with that for the traditional consecutive approach (220.3 ± 27.58 minutes) was observed. Regarding clinical outcomes in the PD patients who underwent subthalamic nucleus DBS implantation, comparing the preoperative off-medication condition with the off-medication/on-stimulation condition 1 year after the surgery in both procedure groups, there was a mean 47.8% ± 9.5% improvement in the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score in the simultaneous group, while the sequential group experienced 47.5% ± 15.8% improvement (p = 0.96). Moreover, a marked reduction in the levodopa-equivalent dose from preoperatively to postoperatively was similar in these 2 groups. The simultaneous bilateral procedure presented major advantages over the traditional sequential approach, with a shorter total operating time. Conclusions A simultaneous stereotactic approach significantly reduces the operation time in bilateral DBS procedures, resulting in decreased microrecording time, contributing to the optimization of functional stereotactic procedures.
KW - Brain shift
KW - Deep brain stimulation
KW - Functional neurosurgery
KW - Microelectrode recording
KW - Movement disorders
KW - Parkinson disease
UR - http://www.scopus.com/inward/record.url?scp=84977079159&partnerID=8YFLogxK
U2 - 10.3171/2015.7.JNS151026
DO - 10.3171/2015.7.JNS151026
M3 - Artículo Científico
C2 - 26684776
AN - SCOPUS:84977079159
SN - 0022-3085
VL - 125
SP - 85
EP - 89
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
IS - 1
ER -