Article
First steps to automatisation: First comparative study between Starfix and conventional deep brain stimulation in 60 cases
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Published: | June 4, 2012 |
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Outline
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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.