Rapid subthalamic nucleus deep brain stimulation lead placement utilising CT/MRI fusion, microelectrode recording and test stimulation.
Subthalamic nucleus (STN) deep brain stimulation (DBS) has become an established treatment strategy for patients with medically refractory Parkinson's disease (PD). There are however numerous strategies employed for STN lead placement. Variations include method of STN localisation, use of microelectrode recording, number of microelectrode recording passes and time taken for the procedure. We describe a relatively simple and rapid technique of STN lead placement utilising CT/ MRI image fusion, microelectrode recording and test stimulation. The first 58 consecutive patients undergoing STN DBS were assessed pre- and post-operatively. UPDRS scores, medication use and any surgical complication were assessed. Bilateral STN DBS was an efficacious treatment option for medically refractory PD. We have described a technique which can be performed with effect and low morbidity, and in a time which is well tolerated by patients.
Coyne
T
T
St Andrews and Wesley Hospitals, Brisbane and Royal North Shore Private Hospital, Sydney, Australia. tcoyne@brizbrain.com.au
Silburn
P
P
Cook
R
R
Silberstein
P
P
Mellick
G
G
Sinclair
F
F
Fracchia
G
G
Wasson
D
D
Stanwell
P
P
D046690:Deep Brain Stimulation / Q000295:instrumentation / Q000379:methods*; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008839:Microelectrodes; D010300:Parkinson Disease / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D020531:Subthalamic Nucleus / Q000473:pathology / Q000601:surgery*