Stimloc固定脑深部电极位置移位的对照性研究

摘要

Objective To determine the extent of lead movement based on the type of burr hole fixation device used to secure the lead [ Stimloc versus Medtronic ( Model 3389 - 40,3387 - 40 ) ].A randomized,blinded design of lead movement measurement was used.Methods A clinical series of 20 individuals undergoing placement of a deep brain stimulation (DBS) system with a total of 35 operativesides were measured lead movement in a randomized,blinded fashion.Compared study performed between Stimloc and Medtronic (Model 3389 -40,3387 -40).Results The overall mean lead movement was significantly less using theStimloc ( 1.8 mm),as compared to the Medtronic ( Model 3389 - 40,3387 - 40 ) ( 3.4 mm ),fixation device.Moreover,the pattern of lead movement was significantly different between the two devices.That was,the majority of measuredmovements using Stimloc device was in the superior direction (43％),whereas the opposite was true for the Medtronic ( Model 3389 - 40,3387 - 40 ) device ( i.e.,83％ with inferior movement).Conclusion The Stimloc burr hole fixation device is associated with significantly less movement when securing the lead.Probable mechanisms of movement are discussed.%目的 通过Stimloc电极固定装置和美敦力早期电极固定装置(Medtronic 3389 - 40,3387 -40)固定脑深部电极位置移位的对照性研究,探讨Stimloc固定电极的稳定性和安全性,以及对早期固定装置的改进.方法 脑深部电刺激术( deep brain stimulation)后复查头颅MRI,计算Stimloc 固定脑深部电极的20例(35侧)患者,电极移位的平均距离.与早期电极固定装置( Medtronic 3389-40,3387 - 40)固定电极(35侧)移位的平均距离进行比较性研究.结果 Stimloc组,35侧电极平均移位1.8 mm,而对照组则达到了3.4 mm.两组数值差异有统计学意义(P=0.04).两组数据显示电极深度的移位差异有统计意义(P =0.006).Stimloc组43％的电极埋置位置过浅,对照组83％的电极埋置位置过深.结论 采用Stimloc固定电极移位的距离明显小于对照组.