gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

First steps to automatisation: First comparative study between Starfix and conventional deep brain stimulation in 60 cases

Meeting Abstract

  • D. Winkler - Klinik und Poliklinik für Neurochirurgie, Universität Leipzig
  • D. Weise - Klinik und Poliklinik für Neurologie, Universität Leipzig
  • T. Hoffmann - Abteilung für Neuroradiologie der Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universität Leipzig
  • J. Meixensberger - Klinik und Poliklinik für Neurochirurgie, Universität Leipzig

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.16.01

doi: 10.3205/12dgnc145, urn:nbn:de:0183-12dgnc1458

Published: June 4, 2012

© 2012 Winkler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: With an individual manufactured platform, based on preoperatively implanted bone markers and screws a new generation of stereotaxic systems is available now. In a retrospective study we evaluated the practicability and reliability of this tool for deep brain stimulation in patients with idiopathic Parkinson disease (PD) and compared surgical, procedure – related and clinical results with the traditional frame based stereotaxy.

Methods: In a prospective study 60 PD patients were treated using a ZD (Zamorano-Dujovny) stereotaxic frame (group I, 29 patients) or a miniframe (microTargeting® platform), FHC (group II, 31 patients). Microrecording and macrostimulation were performed routinely in both groups. Clinical effect (UPDRS) and medication were documented up to 12 months postoperatively.

Results: Evaluation of both procedures confirmed a comparable accuracy of target and electrode positioning and a reduction of surgical time from 234.1 min (group I) to 173.6 min (group II). The reduction of L-Dopa was in both groups significant (p < 0.001): group I: 69.9%, group II: 58.5%. All patients showed an improvement of UPDRS (part III), which was clear in group I (p = 0.061) and significant in group II (p = 0.015).

Conclusions: Both systems guarantee reliable and safe electrode placements with comparable results in the neurological and medical follow-up. Missing adjustment of frame coordinates (group I) and a better handling (group II) reduce the time of surgery markedly and allow a higher comfort for surgeon and patient as well.