脑深部电刺激术同期植入两侧电极精度的对比研究

Comparative study on accuracy of simultaneous bilateral electrodes implantation in DBS

目的探讨脑深部电刺激(DBS)术同期植入两侧电极的精度差异。方法收集北部战区总医院神经外科2017年2月—2019年2月行同期双侧DBS术患者133例。在ROSA机器人辅助下共植入电极266侧,其中丘脑底核(STN)160侧、丘脑腹中间核(nucleus ventralis intermedius,Vim)2侧、苍白球内侧部(Gpi)104侧。所有患者均于术后2 h和术后1周复查头部CT三维重建,并与术前CT图像(手术计划靶点)融合;测量植入电极与计划靶点在靶点平面X轴和Y轴上的误差距离。结果全部266根治疗电极均成功植入,未发生颅内出血、颅内感染和偏瘫等严重并发症,也未出现电极折断现象。术后2 h和术后1周时,第一侧与第二侧植入电极在X轴与Y轴上的误差比较,差异均无统计学意义(均P>0.05)。结论ROSA机器人辅助下DBS术同期植入两侧电极的精度无明显差异。DBS术可以同时植入双侧治疗电极,无需延期手术植入第二侧电极。

Objective To compare the accuracy of simultaneous implantated bilateral electrodes in deep brain stimulation(DBS).Methods 133 patients with bilateral DBS from February 2017 to February 2019 in the department of neurosurgery,the General Hospital of Northen Theater Command were included.A total of 266 electrodes were implanted,including 160 sides of subthalamic nucleus(STN),2 sides of ventromedial nucleus of thalamus and 104 sides of globus pallidus interior(Gpi).All patients underwent three-dimensional reconstruction of the head 2 hours after operation and 1 week after operation,which was fused with the preoperative surgical plan.The distance between the implanted electrode and the preoperative target on the X and Y axes in the target plane was measured.Results All 266 electrodes were successfully implanted,and no serious complications such as intracranial hemorrhage,intracranial infection and hemiplegia occurred,and no electrode fracture occurred.There was no statistically significant difference in the error(all P>0.05),between the first implanted electrode and the second implanted electrode on the X-axis and the Y-axis,neither at 2 hours postoperatively nor 1 week after surgery.Conclusion DBS can accurately implant both electrodes at the same time without delaying the implantation of the second electrode.