ABSTRACT

Objective

To analyze the causes of wire tethering in deep brain stimulation (DBS) and propose ways to prevent it.

Methods

A total of 70 consecutive patients (140 electrodes) operated for DBS in our department from September 2017 to December 2019 were analyzed to document wire tethering, respectively, in the initial period (September 2017–June 2018) and the late period (July 2018–December 2019). The patients come back to our clinic 1 month postoperatively to turn on the equipment and followed up any time postoperatively face to face.

Results

Wire tethering was divided into mild, moderate and severe. The frequency of mild wire tethering was 12.5% (2/16) in the initial period and 9.3% (5/54) in the late period. The frequency of moderate wire tethering was 12.5% (2/16) in the initial period and 3.7% (2/54) in the late period. There was only one patient suffered from severe wire tethering in the initial period and none in the late period. There was a significant difference between the initial (31.3%) and the late (13%) periods in the frequency of total wire tethering.

Conclusions

Wire tethering is a rare but serious hardware complication in DBS which should be noteworthy. Improving surgical skill when implanted the extension wire and inventing new material covering extension wire can prevent wire tethering.

中文翻译：

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防止单一中心在深部脑刺激中电线束缚的经验

摘要

客观的

分析深部脑刺激（DBS）中电线束缚的原因并提出预防方法。

方法

对 2017 年 9 月至 2019 年 12 月在我科进行 DBS 手术的 70 例连续患者（140 个电极）进行分析，分别记录初期（2017 年 9 月-2018 年 6 月）和后期（2018 年 7 月- 2019 年 12 月）。患者术后1个月回到我们诊所打开设备，术后随时进行面对面随访。

结果

电线束缚分为轻度、中度和重度。轻度电线束缚的频率在初期为 12.5% (2/16)，在后期为 9.3% (5/54)。中度电线束缚的频率在初期为 12.5% (2/16)，在后期为 3.7% (2/54)。早期仅有一名患者出现严重的电线束缚，后期则没有。初始 (31.3%) 和后期 (13%) 的总电线束缚频率存在显着差异。

结论

电线束缚是 DBS 中罕见但严重的硬件并发症，应引起注意。在植入延长线时提高手术技巧并发明覆盖延长线的新材料可以防止电线束缚。