Turkish Neurosurgery
Electrode Fixation with Bone Cement or Stimloc® in Deep Brain Stimulation Surgery: A Comparative Study
Onder Taskin1, Ersoy Kocabicak2, Sait Ozturk3, Onur Yildiz4, Yasin Temel5
1Ministry of Health, Çarşamba Government Hospital, Neurosurgery, Samsun,
2Ondokuz Mayıs University, Neurosurgery and Neuromodulation Center, Samsun,
3Firat University, Neurosurgery, Elazig,
4Ondokuz Mayıs University, Neurology, Samsun,
5Maastricht University Medical Center, Neurosurgery and Neuroscience, Maastricht,
DOI: 10.5137/1019-5149.JTN.35635-21.2

Aim:The success of deep brain stimulation (DBS) surgeries depends on the implantation of electrodes toward the target nucleus and fixation to the cranium. This study examined the postoperative outcomes of electrode fixation using bone cement and Stimloc® in patients with Parkinson\'s disease (PD) who underwent subthalamic nucleus (STN) DBS.Material and Methods:Between 2016 and 2018, permanent electrode fixation was performed in 30 patients with PD, of which 15 received bone cement and the remaining 15 received Stimloc®. Data regarding preoperative Unified Parkinson’s Disease Rating Scale (UPDRS) III scores, levodopa equivalent daily dose (LEDD) values, surgery duration, and the fixation technique used were recorded. Brain computed tomography was performed for early postoperative evaluation of pneumocephalus and possible hematoma as well as for the determination of migration 1 year postoperatively. UPDRS III scores and LEDD values were re-evaluated 1 year postoperatively; surgery duration, clinical effectiveness, and complication rates were compared between the two fixation techniques.Results:A statistically significant difference in application time was observed between the two techniques (bone cement: 21 min, Stimloc®: 6 min). After 1 year from surgery, 0.92- and 0.88-mm migrations were observed in the bone cement and Stimloc® groups, respectively. A significant correlation between migration and the pneumocephalus volume was observed in both groups. No differences were observed between the groups regarding infection, migration, pneumocephalus volume, wound erosion, and clinical outcomes.Conclusion:Stimloc® is preferred over bone cement for electrode fixation in DBS surgeries as it is associated with shorter application duration; this increases patient comfort and tolerance during awake surgery. Clinical efficacy and complication rates associated with both techniques are similar.

Corresponding author : Sait Ozturk