Stimloc固定脑深部电极位置移位的对照性研究

Deep brain stimulation lead fixation： a comparative study of the Stimloc and Medtronic burr hole fixation device

目的通过Stimloc电极固定装置和美敦力早期电极固定装置（Medtronic 3389-40，3387-40）固定脑深部电极位置移位的对照性研究，探讨Stimloc固定电极的稳定性和安全性，以及对早期固定装置的改进。方法脑深部电刺激术（deep brain stimulation）后复查头颅MRI，计算Stimloc固定脑深部电极的20例（35侧）患者，电极移位的平均距离。与早期电极固定装置（Medtronic 3389-40，3387-40）固定电极（35侧）移位的平均距离进行比较性研究。结果Stimloc组，35侧电极平均移位1．8mm，而对照组则达到了3．4mm。两组数值差异有统计学意义（P=0．04）。两组数据显示电极深度的移位差异有统计意义（P=0．006）。Stimloc组43％的电极埋置位置过浅，对照组83％的电极埋置位置过深。结论采用Stimloc固定电极移位的距离明显小于对照组。

Objective To determine the extent of lead movement based on the type of burr hole fixation device used to secure the lead [ Stimloc versus Medtronic （ Model 3389 - 40, 3387 - 40 ） ] . A randomized, blinded design of lead movement measurement was used. Methods A clinical series of 20 individuals undergoing placement of a deep brain stimulation （DBS） system with a total of 35 operativesides were measured lead movement in a randomized, blinded fashion. Compared study performed between Stimloc and Medtronic （Model 3389 -40,3387 -40）. Results The overall mean lead movement was significantly less using theStimloc （1.8 mm）, as compared to the Medtronic（ Model 3389 -40,3387 -40） （3.4 ram）, fixation device. Moreover, the pattern of lead movement was significantly different between the two devices. That was, the majority of measuredmovements using Stimloc device was in the superior direction （43%）, whereas the opposite was ：true for the Medtronic （ Model 3389 - 40,3387 - 40 ） device （ i. e. , 83% with inferior movement）. Conclusion The Stimloc burr hole fixation device is associated with significantly less movement when securing the lead. Probable mechanisms of movement are discussed.