• M Fiorella Contarino, Maarten Bot, Johannes D Speelman, Rob M A de Bie, Marina A Tijssen, Damiaan Denys, Lo J Bour, P Richard Schuurman, and Pepijn van den Munckhof.
• Departments of †Neurology; ‡Neurosurgery; and §Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; ¶Department of Neurology, University Medical Centre Groningen, Groningen, the Netherlands.
• Neurosurgery. 2013 Oct 1;73(4):681-8; discussion 188.

BackgroundDisplacement of deep brain stimulation (DBS) electrodes may occur after surgery, especially due to large subdural air collections, but other factors might contribute.ObjectiveTo investigate factors potentially contributing to postoperative electrode displacement, in particular, different lead-anchoring techniques.MethodsWe retrospectively analyzed 55 patients (106 electrodes) with Parkinson disease, dystonia, tremor, and obsessive-compulsive disorder in whom early postoperative and long-term follow-up computed tomography (CT) was performed. Electrodes were anchored with a titanium microplate or with a commercially available plastic cap system. Two independent examiners determined the stereotactic coordinates of the deepest DBS contact on early postoperative and long-term follow-up CT. The influence of age, surgery duration, subdural air volume, use of microrecordings, fixation method, follow-up time, and side operated on first was assessed.ResultsSubdural air collections measured on average 4.3 ± 6.2 cm. Three-dimensional (3-D) electrode displacement and displacement in the X, Y, and Z axes significantly correlated only with the anchoring method, with larger displacement for microplate-anchored electrodes. The average 3-D displacement for microplate-anchored electrodes was 2.3 ± 2.0 mm vs 1.5 ± 0.6 mm for electrodes anchored with the plastic cap (P = .030). Fifty percent of the microplate-anchored electrodes showed 2-mm or greater (potentially relevant) 3-D displacement vs only 25% of the plastic cap-anchored electrodes (P < .01).ConclusionThe commercially available plastic cap system is more efficient in preventing postoperative DBS electrode displacement than titanium microplates. A reliability analysis of the electrode fixation is warranted when alternative anchoring methods are used.

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