Turkish Neurosurgery 2022 , Vol 32 , Num 3
Electrode Fixation with Bone Cement or Stimloc® in Deep Brain Stimulation Surgery: A Comparative Study
1Ministry of Health, Carsamba Government Hospital, Neurosurgery Clinic, Samsun, Turkey
2Ondokuz Mayıs University, School of Medicine, Department of Neurosurgery & Neuromodulation Center, Samsun, Turkey
3Altınbas University, Medical Park Bahcelievler Hospital, Department of Neurosurgery, Istanbul, Turkey
4Ondokuz Mayıs University, School of Medicine, Department of Neurology, Samsun, Turkey
5Maastricht University Medical Center, Departments of Neurosurgery and Neuroscience, Maastricht, The Netherlands
DOI : 10.5137/1019-5149.JTN.35635-21.2 AIM: To examine the postoperative outcomes of electrode fixation using bone cement and Stimloc® in patients with Parkinson?s disease (PD) who underwent subthalamic nucleus (STN) deep brain stimulation (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. Keywords : Deep brain stimulation, Parkinson?s disease, Subthalamic nucleus, Stimloc®, Bone cement

Corresponding author : Sait OZTURK, drsaitozturk@yahoo.com