| A Comparison of Unilateral and Bilateral Tunneling Techniques for the Implantation of Bilateral Neurostimulators during Deep Brain Stimulation Surgery |
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Gun Sang Lee, Ki Myung Lee, Woo Jae Kim, Ho Sang Kim, Jeong Ho Kim, Yun-Suk Kim |
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Department of Neurosurgery, Maryknoll General Hospital, Busan, Korea |
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| Abstract |
Objective
The use of an alternative surgical technique is introduced in this study, namely a unilateral tunneling technique, involving two extensions for the implantation of two leads and two single-channel neurostimulators during bilateral deep brain stimulation (DBS) surgery. The clinical outcomes of this technique were compared to those obtained using the standard bilateral tunneling technique.
Methods
We retrospectively reviewed 65 patients undergoing bilateral DBS, either using the bilateral technique (50 patients ; 100 neurostimulators) or the unilateral tunneling technique (15 patients ; 30 neurostimulators). The lead-extension connector was implanted in a groove in the posterior parietal bone. Clinical outcomes were compared in terms of operating time and events relating to electrode extension, skin infection, and cosmesis, for more than 12 months of follow-up.
Results
The mean follow-up period was 43 and 26 months, and the mean operation time was 151.7 and 113.7 minutes, respectively, for the bilateral and unilateral tunneling techniques. The difference was statistically significant. Cosmesis outcomes associated with the use of the extensions were good (72.0% and 80.0%), fair (22.0% and 13.3%), poor (4.0% and 6.7%), and failure (such as skin infection) (2.0% and 0.0%) for the bilateral and unilateral tunneling techniques, respectively.
Conclusion
The unilateral tunneling technique, whereby two extensions are used, is a reliable alternative method to the bilateral tunneling technique for the implantation of neurostimulators in both sides of the chest during bilateral DBS. |
| Key Words:
Deep brain stimulation, Cosmesis, Complications. |
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