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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Image-guidance in Motor-Cortex-Stimulation - A new promising therapeutic tool in the treatment of intractable pain

Bildgeführte Motor-Cortex-Stimulation - eine neue und vielversprechende Methode zur Schmerztherapie

Meeting Abstract

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  • corresponding author Jochen Rohlfs - Department of Neurosurgery, Philipps-University Marburg, Marburg
  • D. Hellwig - Department of Neurosurgery, Philipps-University Marburg, Marburg
  • T. Riegel - Department of Neurosurgery, Philipps-University Marburg, Marburg
  • H. Bertalanffy - Department of Neurosurgery, Philipps-University Marburg, Marburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.06.08

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0209.shtml

Published: April 23, 2004

© 2004 Rohlfs et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

Epidural electrical stimulation of the motor cortex is a promising therapy option in patients with intractable pain. We present our experience with this therapeutic tool on the basis of five patients treated during the last year.

Methods

Five patients with refractory chronical pain were treated by motor cortex stimulation with a quadripolar electrode. The placement of the electrode array was planed with the functional MRI to localize the precentral gyrus. The surgical procedure was performed with the support of the neuronavigation system and the cortical stimulation.

Results

The positioning of the burhole above the prerolandic area and the precentral gyrus could be easily located using the image guidance in all cases. The exact location of the electrode was determined by cortical stimulation increasing amplitude up to motor threshold. The stimulation parameters were adjusted to neurological effect. No complications were observed throughout the procedures. After the intervention all patients showed a good to excellent improvement of pain.

Conclusions

With the use of fMRI, image guidance and cortical stimulation a precise and safe placement of the qudripolar electrode through a single burhole can be performed easily. An excellent correlation between the image guided target location and the elcectrode placement respectively cortical stimulation could be demonstrated. This new method offers a safe, effective and minimal invasive option for the treatment of patients with intractable pain.