Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 3;11(5):592.
doi: 10.3390/brainsci11050592.

Single-Stage Deep Brain Stimulator Placement for Movement Disorders: A Case Series

Arrin Brooks  1 , Alastair T Hoyt  2
Affiliations

Single-Stage Deep Brain Stimulator Placement for Movement Disorders: A Case Series

Arrin Brooks et al. Brain Sci. .

Abstract

With more than two decades of experience and thousands of patients treated worldwide, deep brain stimulation (DBS) has established itself as an efficacious and common surgical treatment for movement disorders. However, a substantial majority of patients in the United States still undergo multiple, "staged" surgeries to implant a DBS system. Despite several reports suggesting no significant difference in complications or efficacy between staged and non-staged approaches, the continued use of staging implies surgeons harbor continued reservations about placing all portions of a system during the index procedure. In an effort to eliminate multiple surgeries and simplify patient care, DBS implantations at our institution have been routinely performed in a single surgery over the past four years. Patients who underwent placement of new DBS systems at our institution from January 2016 to June 2019 were identified and their records were reviewed. Revision surgeries were excluded. Total operative time, length of stay and rates of surgical site infections, lead fracture or migration, and other complications were evaluated. This series expands the body of evidence suggesting placement of a complete DBS system during a single procedure appears to be an efficacious and well-tolerated option.

Keywords: deep brain stimulation; interoperative neurophysiology; movement disorders; stereotactic surgery; surgical technique.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Unilateral versus bilateral placement in included patients.
Figure 2
Figure 2
Conditions treated and brain targets in included patients.
Figure 3
Figure 3
Flow chart of outcomes.
See this image and copyright information in PMC

References

    1. Guzzi G., Della Torre A., Chirchiglia D., Volpentesta G., Lavano A. Critical reappraisal of DBS targeting for movement disorders. J. Neurosurg. Sci. 2016;60:181–188. - PubMed
    1. Lee D.J., Lozano C.S., Dallapiazza R.F., Lozano A.M. Current and future directions of deep brain stimulation for neurological and psychiatric disorders. J. Neurosurg. 2019;131:333. doi: 10.3171/2019.4.JNS181761. - DOI - PubMed
    1. Abosch A., Timmermann L., Bartley S., Rietkerk H.G., Whiting D., Connolly P.J., Lanctin D., Hariz M.I. An international survey of deep brain stimulation procedural steps. Stereotact. Funct. Neurosurg. 2013;91:1–11. doi: 10.1159/000343207. - DOI - PubMed
    1. Winkler D., Tittgemeyer M., Schwarz J., Preul C., Strecker K., Meixensberger J. The first evaluation of brain shift during functional neurosurgery by deformation field analysis. J. Neurol. Neurosurg. Psychiatry. 2005;76:1161–1163. doi: 10.1136/jnnp.2004.047373. - DOI - PMC - PubMed
    1. Peng S., Levine D., Ramirez-Zamora A., Chockalingam A., Feustel P.J., Durphy J., Hanspal E., Novak P., Pilitsis J.G. A comparison of unilateral deep brain stimulation (DBS), simultaneous bilateral DBS, and staged bilateral DBS lead accuracies. Neuromodul. J. Int. Neuromodul. Soc. 2017;20:478–483. doi: 10.1111/ner.12588. - DOI - PubMed

LinkOut - more resources