Asleep Deep Brain Stimulator Placement in the Intraoperative Magnetic Resonance Imaging System Hybrid Operating Suite: 2-Dimensional Operative Video.
Asleep Deep Brain Stimulator Placement in the Intraoperative Magnetic Resonance Imaging System Hybrid Operating Suite: 2-Dimensional Operative Video.
复制标题
术中磁共振成像系统混合手术套件中放置睡眠深部脑刺激器：二维手术视频。
DOI：
10.1093/ons/opaa337
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Rolston,JohnD
中科院分区：
文献类型：
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作者：
Brock,AndreaA;Kundu,Bornali;Rolston,JohnD
在睡眠中，图像引导的脑深部刺激(DBS)正迅速普及，因为它提供了更好的患者舒适度和与使用微电极记录的基于帧的方法相媲美的准确性。1在本视频中，我们演示了使用无框架、立体定向ClearPoint系统(位于加利福尼亚州欧文的MRI干预公司)在术中磁共振成像混合操作套件(IMRIS；明尼苏达州明尼通卡鹿场成像公司)内放置DBS电极的方案。1-4该系统使用头盖式瞄准装置，结合手术中顺序的磁共振成像引导，将DBS导联放置到皮质下靶点。2、5重要的是，这种方法允许患者在手术过程中保持睡眠，不需要药物假期或额外的微电极记录设备。文献表明，它具有与唤醒方法相当的精度1、6和结果2。我们用一例帕金森病患者演示了这项技术，他需要在双侧丘脑底核放置导联。7-9患者同意手术和发表。演示了患者的位置、覆盖的细微差别、初始的间接目标和最终的直接目标。手术的风险包括出血、硬件故障和感染的风险。10DBS目前是帕金森病患者的一种未得到充分利用的治疗选择。11对于许多对清醒手术持谨慎态度的患者来说，提供睡眠选项可能更容易接受。
Asleep, image-guided deep brain stimulation (DBS) placement is rapidly gaining popularity because it offers greater patient comfort and comparable accuracy with frame-based methods using microelectrode recording. 1 In this video, we demonstrate our protocol to use the frameless, stereotactic ClearPoint system (MRI Interventions Inc, Irvine, California) to place DBS electrodes within an intraoperative magnetic resonance imaging hybrid operating suite (IMRIS; Deerfield Imaging Inc, Minnetonka, Minnesota). 1-4 This system uses a skull-mounted aiming device coupled with sequential, intraoperative magnetic resonance imaging guidance to direct DBS lead placement to subcortical targets. 2, 5 Importantly, this method allows the patient to remain asleep during the operation and does not require medication holidays or additional microelectrode recording equipment. The literature indicates it has comparable accuracy 1, 6 and outcomes 2 with the awake method. We demonstrate this technique with the case of a patient with Parkinson disease who required lead placement in the bilateral subthalamic nuclei. 7-9 The patient consented to the procedure and publication. Patient positioning, draping nuances, initial indirect targeting, and final direct targeting are demonstrated. Risks of the operation include a risk of hemorrhage, hardware failure, and infection. 10 DBS is currently an underutilized treatment option for patients with Parkinson disease. 11 Offering the asleep option may be more tolerable for many patients who are wary of awake surgery.