The Procedure of Cables Insertion in Deep Brain Stimulation Surgery

Kim, Eun Young; Kim, Jae Myung; Yoo, Chan Jong; Lee, Uhn

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2011;7(1):37-40.
Published online June 30, 2011.

The Procedure of Cables Insertion in Deep Brain Stimulation Surgery

Eun Young Kim, Jae Myung Kim, Chan Jong Yoo, Uhn Lee

Department of Neurosurgery, Gachon University Gil Hospital, Incheon, Korea

Abstract

Objective
s: This article suggests less invasive and safer method of subcutaneous tunneling and insertion of distal part of electrode and extension cables for Deep Brain Stimulation using a lead cap.
Methods
After securing the electrode on the margin of burr hole, the distal end of electrode was connected to the lead cap and fixed with a setscrew. And then we made a pocket in the loose connective tissue of scalp to put the remained distal part of electrode. The end of the electrode which was covered with the lead cap was deeply pushed in the subcutaneous pocket. The operation was finished by suturing layer by layer. In the step of connecting between the electrode and the extension connector under general anesthesia, we just made an incision on protruded cap site, pulled the cap out, and made a tunnel between the incision site and the subclavicular site for Implanted Pulse Generator (IPG). Through the tunnel, the extension cable was inserted to the incision site and connected with the end of electrode.
Results
Patients’ age was 61 year-old in average. 33 Patients were Idiopathic Parkinson’s disease, 9 essential tremor, and 2 dystonia. One patient developed fracture of extension cable two months after the operation. No other hardware related complications including skin erosion were reported.
Conclusions
This technique doesn’t need to open the burr hole site again to connect with the extension cable. Additional small incision on parietal scalp might help save the operation time and avoid skin erosion.

Key Words: Deep Brain Stimulation (DBS), Electrode, Extension.