Objective To explore the accuracy, efficiency and safety of robot-assisted craniotomy system named Cranibot. Methods The robot system called Cranibot was developed by Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital and Institute of Intelligent Robotics, Beijing Institute of Technology and then employed to carry out randomized controlled experiments on 3 kinds of subjects including 8 3D-printing PVC (polyvinyl chloride) skull models, 5 cadaveric pig heads and 5 living Bama miniature pigs. Both left and right sides were symmetrically selected in each subject to perform craniotomy, and on each side 4 holes were drilled to form a square bone flap. One part of the skull on one side was randomly categorized into the experimental group in which craniotomy was performed by robot system, and its symmetrical part of skull on the other side belonged to the control group in which craniotomy was performed by the same neurosurgeon team. We observed and measured the drilling position error, time spent on craniotomy and incidence of tissue injury in the two groups. Results In skull model experiments, the average position error and time spent on craniotomy of "robot" group were 1.87±0.66 mm and 6.64±1.15 min, and those of "surgeon" group were 3.14±0.73 mm and 8.06±1.10 min respectively. The differences were statistically significant (both P 0.05). Conclusion The robot-assisted craniotomy system named Cranibot could improve the accuracy and efficiency of craniotomy, while its safety requires further research with large sample size. Key words: Robotics; Neurosurgical procedures; Man-machine systems; Models, animal
{"title":"Experimental research on efficacy of intelligent human-machine collaborative robot-assisted cranio-tomy system","authors":"M. Cui, Xiaodong Ma, Meng Zhang, X. Duan, Tengfei Cui, Dingqiang Han, Wenxi Zhu","doi":"10.3760/CMA.J.ISSN.1001-2346.2020.01.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2020.01.018","url":null,"abstract":"Objective \u0000To explore the accuracy, efficiency and safety of robot-assisted craniotomy system named Cranibot. \u0000 \u0000 \u0000Methods \u0000The robot system called Cranibot was developed by Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital and Institute of Intelligent Robotics, Beijing Institute of Technology and then employed to carry out randomized controlled experiments on 3 kinds of subjects including 8 3D-printing PVC (polyvinyl chloride) skull models, 5 cadaveric pig heads and 5 living Bama miniature pigs. Both left and right sides were symmetrically selected in each subject to perform craniotomy, and on each side 4 holes were drilled to form a square bone flap. One part of the skull on one side was randomly categorized into the experimental group in which craniotomy was performed by robot system, and its symmetrical part of skull on the other side belonged to the control group in which craniotomy was performed by the same neurosurgeon team. We observed and measured the drilling position error, time spent on craniotomy and incidence of tissue injury in the two groups. \u0000 \u0000 \u0000Results \u0000In skull model experiments, the average position error and time spent on craniotomy of \"robot\" group were 1.87±0.66 mm and 6.64±1.15 min, and those of \"surgeon\" group were 3.14±0.73 mm and 8.06±1.10 min respectively. The differences were statistically significant (both P 0.05). \u0000 \u0000 \u0000Conclusion \u0000The robot-assisted craniotomy system named Cranibot could improve the accuracy and efficiency of craniotomy, while its safety requires further research with large sample size. \u0000 \u0000 \u0000Key words: \u0000Robotics; Neurosurgical procedures; Man-machine systems; Models, animal","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"73-77"},"PeriodicalIF":0.0,"publicationDate":"2020-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49082630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.010
Yongjie Zhu, Gang Wang, Jun-ping He, Z. Gao, Jing Qian, D. Qiu, Lei Zheng, Xinfa Wang, Rui Zhang
Objective To explore the surgical method and outcome of craniosynostosis combined with Chiari malformation in children. Methods A retrospective analysis was conducted on the clinical data of 16 children with craniosynostosis combined with Chiari malformation who were admitted to Department of Neurosurgery, Children′s Hospital of Nanjing Medical University from April to December 2017. All cases were retrospectively analyzed and their imaging results were analyzed. Of the 16 children without hydrocephalus, 12 underwent craniofacial reconstruction of cranial suture or craniofacial reconstruction, of which 1 case underwent posterior fossa reconstruction and suboccipital decompression at 7 months post operation. In 4 children with combined hydrocephalus, 3 underwent routine right ventricle-peritoneal shunting and cranial reconstruction, of which 1 case was treated with posterior fossa reconstruction and suboccipital decompression at 5 months post operation. The other 1 case was Pfeiffer syndrome and underwent right ventricle-peritoneal shunting plus posterior fossa reconstruction as well as suboccipital decompression. At 3, 6 and 12 months post operation, all patients were followed up at the outpatient clinic and underwent the reexamination of head MRI for assessment of brain tissue development, ventricle changes and cerebellum tonsil herniation. Results All 16 children underwent operation successfully without any surgical complications. Revealed by the postoperative skull CT, all the children′s cranial cavity volume was enlarged, and the cranial malformation was improved. The follow-up time of 16 children was (12.1±2.0) months (10-18 months). The review of head MRI showed that brain tissue developed well and the position of the cerebellar tonsils did not decline further. All children were free of neurological deficits, and parents were satisfied with the improvement in the appearance of their skulls and faces. Conclusions The combination of craniosynostosis with Chiari malformation should be fully evaluated before surgery and appropriate individualized treatment program should be selected according to specific conditions. One-stage craniofacial surgery seems an effective treatment method. Key words: Craniosynostosis; Arnold-Chiari malformation; Child; Treatment outcome
{"title":"Treatment analysis of craniosynostosis combined with Chiari malformation in children","authors":"Yongjie Zhu, Gang Wang, Jun-ping He, Z. Gao, Jing Qian, D. Qiu, Lei Zheng, Xinfa Wang, Rui Zhang","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.010","url":null,"abstract":"Objective \u0000To explore the surgical method and outcome of craniosynostosis combined with Chiari malformation in children. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on the clinical data of 16 children with craniosynostosis combined with Chiari malformation who were admitted to Department of Neurosurgery, Children′s Hospital of Nanjing Medical University from April to December 2017. All cases were retrospectively analyzed and their imaging results were analyzed. Of the 16 children without hydrocephalus, 12 underwent craniofacial reconstruction of cranial suture or craniofacial reconstruction, of which 1 case underwent posterior fossa reconstruction and suboccipital decompression at 7 months post operation. In 4 children with combined hydrocephalus, 3 underwent routine right ventricle-peritoneal shunting and cranial reconstruction, of which 1 case was treated with posterior fossa reconstruction and suboccipital decompression at 5 months post operation. The other 1 case was Pfeiffer syndrome and underwent right ventricle-peritoneal shunting plus posterior fossa reconstruction as well as suboccipital decompression. At 3, 6 and 12 months post operation, all patients were followed up at the outpatient clinic and underwent the reexamination of head MRI for assessment of brain tissue development, ventricle changes and cerebellum tonsil herniation. \u0000 \u0000 \u0000Results \u0000All 16 children underwent operation successfully without any surgical complications. Revealed by the postoperative skull CT, all the children′s cranial cavity volume was enlarged, and the cranial malformation was improved. The follow-up time of 16 children was (12.1±2.0) months (10-18 months). The review of head MRI showed that brain tissue developed well and the position of the cerebellar tonsils did not decline further. All children were free of neurological deficits, and parents were satisfied with the improvement in the appearance of their skulls and faces. \u0000 \u0000 \u0000Conclusions \u0000The combination of craniosynostosis with Chiari malformation should be fully evaluated before surgery and appropriate individualized treatment program should be selected according to specific conditions. One-stage craniofacial surgery seems an effective treatment method. \u0000 \u0000 \u0000Key words: \u0000Craniosynostosis; Arnold-Chiari malformation; Child; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1236-1239"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43912469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.008
Zhipeng Shen, H. Zeng, Wujie Shi, Peiliang Zhang, Jianbin Weng, L. Pan, Chao Lin
Objective To explore the efficacy and safety of small-incision untethering surgery in the treatment of tethered cord syndrome (TCS) in children. Methods We retrospectively collected the clinical data of TCS patients who underwent merely untethering surgery at Department of Neurosurgery, Children′s Hospital, Zhejiang University School of Medicine from May 2015 to May 2018. A total of 72 cases were included and all required transection of merely terminal filament. Among them, there were 33 patients undergoing small-incision operation (small-incision group) and 39 undergoing traditional surgery (traditional group). Comparative analysis of intraoperative incision size, postoperative complications, length of stay and postoperative treatment effect were implemented in both groups. Results All 72 patients underwent surgery successfully. None of the children in the small incision group needed to have the incision extended. In small-incision and tradition groups, the length of the incision was (2.5±0.3)cm and (4.8±1.9)cm respectively, and the length of stay was (4.4±1.8)days and (6.7±2.6)days respectively. Both differences were statistically significant (P 0.05). At the end of follow-up, the total effective rate in traditional group (> 6-41 months) was 89.7% (35/39), while that in small-incision group (>6-27 months) was 93.9% (31/33). There was no statistically difference between them (P>0.05). Conclusion The small-incision untethering for children with TCS who need merely transection of terminal filament seems as effective as traditional large-incision surgery. It has the advantages of small trauma and short length of stay. Key words: Tethered cord syndrome; Child; Microsurgery; Minimally invasive
{"title":"Efficacy of small-incision untethering surgery on tethered cord syndrome in children","authors":"Zhipeng Shen, H. Zeng, Wujie Shi, Peiliang Zhang, Jianbin Weng, L. Pan, Chao Lin","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.008","url":null,"abstract":"Objective \u0000To explore the efficacy and safety of small-incision untethering surgery in the treatment of tethered cord syndrome (TCS) in children. \u0000 \u0000 \u0000Methods \u0000We retrospectively collected the clinical data of TCS patients who underwent merely untethering surgery at Department of Neurosurgery, Children′s Hospital, Zhejiang University School of Medicine from May 2015 to May 2018. A total of 72 cases were included and all required transection of merely terminal filament. Among them, there were 33 patients undergoing small-incision operation (small-incision group) and 39 undergoing traditional surgery (traditional group). Comparative analysis of intraoperative incision size, postoperative complications, length of stay and postoperative treatment effect were implemented in both groups. \u0000 \u0000 \u0000Results \u0000All 72 patients underwent surgery successfully. None of the children in the small incision group needed to have the incision extended. In small-incision and tradition groups, the length of the incision was (2.5±0.3)cm and (4.8±1.9)cm respectively, and the length of stay was (4.4±1.8)days and (6.7±2.6)days respectively. Both differences were statistically significant (P 0.05). At the end of follow-up, the total effective rate in traditional group (> 6-41 months) was 89.7% (35/39), while that in small-incision group (>6-27 months) was 93.9% (31/33). There was no statistically difference between them (P>0.05). \u0000 \u0000 \u0000Conclusion \u0000The small-incision untethering for children with TCS who need merely transection of terminal filament seems as effective as traditional large-incision surgery. It has the advantages of small trauma and short length of stay. \u0000 \u0000 \u0000Key words: \u0000Tethered cord syndrome; Child; Microsurgery; Minimally invasive","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1226-1230"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42258197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.004
Chunhui Yang, Qing Yuan, Xi Wu, Jinyu Xu, Jiali Wang
Objective To investigate the short-term efficacy of STN-DBS (subthalamic nucleus-deep brain stimulation) in patients with Parkinson′s disease and an improvement rate of <30% in levodopa challenge test (LCT). Methods A retrospective analysis was conducted on the clinical data of 35 patients with Parkinson′s disease and an improvement rate of <30% in LCT who underwent STN-DBS from March 2015 to December 2017 at Department of Neurosurgery, Changhai Hospital Affiliated to Navy Medical University. All those patients were divided into tremor dominant (TD) type (n=12), postural instability/gait disturbance (PIGD) type (n=17) and indeterminate type (n=6) according to the motor symptoms of Parkinson′s disease. The preoperative LCT improvement rate and the improvement rate of motor symptoms in an on-stimulation off-medication state (referred to as the postoperative improvement rate of motor movement symptoms) were compared in 3 groups of patients. Comparison and analysis were conducted on the improvement rate of LCT before surgery and the improvement rate of motor symptoms at 1 month post STN-DBS. Results The improvement rates in LCT of TD, PIGD and indeterminate types of patients prior to operation were (19.38±6.85)%, (23.76±5.02)% and (16.48±10.00)% respectively. There was no statistical difference among the 3 groups (F=2.31, P=0.12). The postoperative improvement rates of motor symptoms in those 3 types were (51.75±8.65)%, (41.52±13.11)% and (38.90±14.15)% respectively. There was significant difference among the groups (F=3.39, P=0.04). The postoperative improvement rate of motor symptoms was significantly higher than the improvement rate in preoperative LCT in 35 patients (t=9.46, P<0.01) and in subgroup aualysis(P<0.01 respectively). The elevation from preoperative improvement rate in LCT to post-DBS improvement rate of motor symptoms in 3 groups of patients was statistically significant (F=4.12, P=0.03), and the difference between TD and PIGD types was statistically significant (P=0.02). Conclusion STN-DBS seems effective for improving the motor symptoms of Parkinson′s disease patients with LCT<30%, particularly in TD types in terms of short-term outcome. Key words: Parkinson disease; Tremor; Deep brain stimulation; Levodopa challenge test; Treatment outcome
{"title":"Short-term efficacy analysis of STN-DBS for Parkinson′s disease in patients with low improvement rate in levodopa challenge test","authors":"Chunhui Yang, Qing Yuan, Xi Wu, Jinyu Xu, Jiali Wang","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.004","url":null,"abstract":"Objective To investigate the short-term efficacy of STN-DBS (subthalamic nucleus-deep brain stimulation) in patients with Parkinson′s disease and an improvement rate of <30% in levodopa challenge test (LCT). Methods A retrospective analysis was conducted on the clinical data of 35 patients with Parkinson′s disease and an improvement rate of <30% in LCT who underwent STN-DBS from March 2015 to December 2017 at Department of Neurosurgery, Changhai Hospital Affiliated to Navy Medical University. All those patients were divided into tremor dominant (TD) type (n=12), postural instability/gait disturbance (PIGD) type (n=17) and indeterminate type (n=6) according to the motor symptoms of Parkinson′s disease. The preoperative LCT improvement rate and the improvement rate of motor symptoms in an on-stimulation off-medication state (referred to as the postoperative improvement rate of motor movement symptoms) were compared in 3 groups of patients. Comparison and analysis were conducted on the improvement rate of LCT before surgery and the improvement rate of motor symptoms at 1 month post STN-DBS. Results The improvement rates in LCT of TD, PIGD and indeterminate types of patients prior to operation were (19.38±6.85)%, (23.76±5.02)% and (16.48±10.00)% respectively. There was no statistical difference among the 3 groups (F=2.31, P=0.12). The postoperative improvement rates of motor symptoms in those 3 types were (51.75±8.65)%, (41.52±13.11)% and (38.90±14.15)% respectively. There was significant difference among the groups (F=3.39, P=0.04). The postoperative improvement rate of motor symptoms was significantly higher than the improvement rate in preoperative LCT in 35 patients (t=9.46, P<0.01) and in subgroup aualysis(P<0.01 respectively). The elevation from preoperative improvement rate in LCT to post-DBS improvement rate of motor symptoms in 3 groups of patients was statistically significant (F=4.12, P=0.03), and the difference between TD and PIGD types was statistically significant (P=0.02). Conclusion STN-DBS seems effective for improving the motor symptoms of Parkinson′s disease patients with LCT<30%, particularly in TD types in terms of short-term outcome. Key words: Parkinson disease; Tremor; Deep brain stimulation; Levodopa challenge test; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1205-1209"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41575260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.002
F. Ji, Dou Wanchen, W. Xinhua, Wang Lin, Yang Yingmai, Guo Yi, M. Wenbin, Wang Renzhi
Objective To explore the feasibility and efficacy of deep brain stimulation (DBS) in the treatment of generalized dystonia in children. Methods A retrospective study was designed to investigate the clinical data of 12 children with generalized dystonia. All of them were treated with DBS at Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from August 2015 to July 2018. Genetic etiology testing showed that 5 cases were type DYT-1, 1 case was type DYT-6, and 6 cases were idiopathic generalized dystonia. All children underwent head susceptibility-weighted imaging (SWI) to locate the target before surgery. The clinical efficacy of the children was assessed using the Burke-Fahn-Marsden dystonia rating scale (BFMDRS). In addition, 12 adult patients with generalized dystonia with matched gender, genotype were selected from our database. We compared and analyzed the difference in anatomy of the internal globus pallidus (GPi) between children and adults to evaluate the feasibility of operation. Results All patients were successfully implanted with electrodes without surgery-related complications. The average duration of follow-up was (19.8±9.6) months (12-47 months). The median BFMDRS scores at 3 months and 1 year after surgery were 15.5 (10-50) and 12.5 (4-48) respectively, which, compared with the preoperative score of 49.0(28-103), were significantly different (both P 8 years old was (75.5±4.7)mm (70.0-82.8 mm), which was not statistically different from that in the adults group (P=0.190). Conclusions Preliminary findings suggest that DBS could improve clinical symptoms without serious complications for the treatment of pediatric generalized dystonia with clear etiological causes. The anatomical location of the GPi in children >8 years old is not significantly different from that in adults. However, the long-term prognosis and incidence of complications such as electrode displacement still require more follow-up studies. Key words: Dystonia; Child; Deep brain stimulation; Generalized
{"title":"Outcome analysis of deep brain stimulation for pediatric generalized dystonia","authors":"F. Ji, Dou Wanchen, W. Xinhua, Wang Lin, Yang Yingmai, Guo Yi, M. Wenbin, Wang Renzhi","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.002","url":null,"abstract":"Objective \u0000To explore the feasibility and efficacy of deep brain stimulation (DBS) in the treatment of generalized dystonia in children. \u0000 \u0000 \u0000Methods \u0000A retrospective study was designed to investigate the clinical data of 12 children with generalized dystonia. All of them were treated with DBS at Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from August 2015 to July 2018. Genetic etiology testing showed that 5 cases were type DYT-1, 1 case was type DYT-6, and 6 cases were idiopathic generalized dystonia. All children underwent head susceptibility-weighted imaging (SWI) to locate the target before surgery. The clinical efficacy of the children was assessed using the Burke-Fahn-Marsden dystonia rating scale (BFMDRS). In addition, 12 adult patients with generalized dystonia with matched gender, genotype were selected from our database. We compared and analyzed the difference in anatomy of the internal globus pallidus (GPi) between children and adults to evaluate the feasibility of operation. \u0000 \u0000 \u0000Results \u0000All patients were successfully implanted with electrodes without surgery-related complications. The average duration of follow-up was (19.8±9.6) months (12-47 months). The median BFMDRS scores at 3 months and 1 year after surgery were 15.5 (10-50) and 12.5 (4-48) respectively, which, compared with the preoperative score of 49.0(28-103), were significantly different (both P 8 years old was (75.5±4.7)mm (70.0-82.8 mm), which was not statistically different from that in the adults group (P=0.190). \u0000 \u0000 \u0000Conclusions \u0000Preliminary findings suggest that DBS could improve clinical symptoms without serious complications for the treatment of pediatric generalized dystonia with clear etiological causes. The anatomical location of the GPi in children >8 years old is not significantly different from that in adults. However, the long-term prognosis and incidence of complications such as electrode displacement still require more follow-up studies. \u0000 \u0000 \u0000Key words: \u0000Dystonia; Child; Deep brain stimulation; Generalized","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1195-1199"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43523270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.013
Li D Zhang, Handong Wang, Yunxi Pan, Ke Ding, Jianhong Zhu
Objective To analyze the diagnosis and treatment of spinal dural arteriovenous fistula (SDAVF). Methods The clinical data of 14 patients with SDAVF admitted to Department of Neurosurgery, General Hospital of the Eastern Theater Command from May 2008 to May 2018 were analyzed retrospectively. All patients underwent the examinations of preoperative spinal cord MRI and spinal cord angiography to identify the region of SDAVF and the location of fistula. Microsurgical resection of SDAVF was conducted via semi-lamina approach. The modified Aminoff-Logue score was used to evaluate the spinal function before operation, after operation and during the follow-up period. Results No abnormal fistulas or tortuous dilated drainage veins were detected by spinal cord angiography after operation in 14 patients. The modified Aminoff-Logue score [median (upper and lower quartiles)] before operation and post operation in those 14 patients were as follows: gait: 2.0 (1.0, 3.0) points vs. 2.0 (1.0, 2.0) points, urinate: 2.0 (0, 2.0) points vs. 1.0 (0, 2.0) points, defecate: 1.0 (0, 2.0) points vs. 0.5 (0, 1.0) points. The postoperative scores were improved compared to preoperative scores (all P<0.05). Of those 14 patients, 6 were lost to follow-up and 8 were followed up for 7.5 (4.5, 12.0) months. The gait, urinate and defecate scores were 0.5 (0, 1.0), 0 (0, 0.7) and 0 (0, 0.5) respectively, which have improved compared with those before operation (all P<0.05). No recurrence of the lesion was found in 8 patients during the last follow-up. Conclusions Spinal cord angiography is the gold standard for the diagnosis of SDAVF. Microsurgery via semi-lamina approach is an effective method for the treatment of SDAVF. The spinal cord function of patients can be improved significantly. Key words: Arteriovenous fistula; Spinal dura; Microsurgery; Clinical characteristics; Spinal cord function
{"title":"Diagnosis and treatment of spinal dural arteriovenous fistula: A report of 14 cases","authors":"Li D Zhang, Handong Wang, Yunxi Pan, Ke Ding, Jianhong Zhu","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.013","url":null,"abstract":"Objective \u0000To analyze the diagnosis and treatment of spinal dural arteriovenous fistula (SDAVF). \u0000 \u0000 \u0000Methods \u0000The clinical data of 14 patients with SDAVF admitted to Department of Neurosurgery, General Hospital of the Eastern Theater Command from May 2008 to May 2018 were analyzed retrospectively. All patients underwent the examinations of preoperative spinal cord MRI and spinal cord angiography to identify the region of SDAVF and the location of fistula. Microsurgical resection of SDAVF was conducted via semi-lamina approach. The modified Aminoff-Logue score was used to evaluate the spinal function before operation, after operation and during the follow-up period. \u0000 \u0000 \u0000Results \u0000No abnormal fistulas or tortuous dilated drainage veins were detected by spinal cord angiography after operation in 14 patients. The modified Aminoff-Logue score [median (upper and lower quartiles)] before operation and post operation in those 14 patients were as follows: gait: 2.0 (1.0, 3.0) points vs. 2.0 (1.0, 2.0) points, urinate: 2.0 (0, 2.0) points vs. 1.0 (0, 2.0) points, defecate: 1.0 (0, 2.0) points vs. 0.5 (0, 1.0) points. The postoperative scores were improved compared to preoperative scores (all P<0.05). Of those 14 patients, 6 were lost to follow-up and 8 were followed up for 7.5 (4.5, 12.0) months. The gait, urinate and defecate scores were 0.5 (0, 1.0), 0 (0, 0.7) and 0 (0, 0.5) respectively, which have improved compared with those before operation (all P<0.05). No recurrence of the lesion was found in 8 patients during the last follow-up. \u0000 \u0000 \u0000Conclusions \u0000Spinal cord angiography is the gold standard for the diagnosis of SDAVF. Microsurgery via semi-lamina approach is an effective method for the treatment of SDAVF. The spinal cord function of patients can be improved significantly. \u0000 \u0000 \u0000Key words: \u0000Arteriovenous fistula; Spinal dura; Microsurgery; Clinical characteristics; Spinal cord function","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1249-1253"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48213140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.003
R. Zong, Xin Xu, Zhiqi Mao, Zhi-qiang Cui, Guang Xie, Xu O Zhang, Longsheng Pan, Xinguang Yu
Objective To verify the feasibility of remote manipulation of deep brain stimulation (DBS) with 5G communication for the treatment of brain diseases. Methods In March 2019, 3 patients(2 parkinson′s disease and 1 essential tremor) who planned to undergo DBS at Department of Neurosurgery, the First Medical Center of the PLA General Hospital were prospectively recruited into this study. The 5G communication links were established between Beijing and Sanya, Hainan (Hainan Hospital of PLA Gerenal Hospital). The operation group completed the steps such as installation of head frame, craniotomy, microelectrode puncture for the patients in the operation room in Beijing. The remote-control group completed the steps such as remote surgery planning, remote control of microelectrode recording (MER), and imaging results confirmation of electrode implantation. Results During remote surgical procedures under 5G communication, the maximum downlink peak rate was 119 Mbps, the uplink peak rate was 27 Mbs, and the average delay was 76 ms. During the operation, the remote control of the MER drive system ran smoothly and there was no delay of signal transmission. The voice and picture of the operating room and the MER signal were transmitted smoothly. The operation was completed successfully. There were no complications such as puncture bleeding, infection and skin ulceration after the operation. At 3-month follow-up, based on clinical rating scale for tremor (CRST) the score of essential tremor patient was improved by 43.6%; the UPDRS (unified Parkinson disease rating scale)-Ⅲ scores of 2 Parkinson′s disease patients were improved by 84.9% and 90.5% respectively. Conclusion The remote control of MER in DBS surgery with 5G communication seems to have certain feasibility. Key words: Parkinson disease; Essential tremor; Deep brain stimulation; 5G communication; Remote control surgery
{"title":"Preliminary study of the treatment of brain diseases by remote manipulation of deep brain stimulation with 5G communication","authors":"R. Zong, Xin Xu, Zhiqi Mao, Zhi-qiang Cui, Guang Xie, Xu O Zhang, Longsheng Pan, Xinguang Yu","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.003","url":null,"abstract":"Objective \u0000To verify the feasibility of remote manipulation of deep brain stimulation (DBS) with 5G communication for the treatment of brain diseases. \u0000 \u0000 \u0000Methods \u0000In March 2019, 3 patients(2 parkinson′s disease and 1 essential tremor) who planned to undergo DBS at Department of Neurosurgery, the First Medical Center of the PLA General Hospital were prospectively recruited into this study. The 5G communication links were established between Beijing and Sanya, Hainan (Hainan Hospital of PLA Gerenal Hospital). The operation group completed the steps such as installation of head frame, craniotomy, microelectrode puncture for the patients in the operation room in Beijing. The remote-control group completed the steps such as remote surgery planning, remote control of microelectrode recording (MER), and imaging results confirmation of electrode implantation. \u0000 \u0000 \u0000Results \u0000During remote surgical procedures under 5G communication, the maximum downlink peak rate was 119 Mbps, the uplink peak rate was 27 Mbs, and the average delay was 76 ms. During the operation, the remote control of the MER drive system ran smoothly and there was no delay of signal transmission. The voice and picture of the operating room and the MER signal were transmitted smoothly. The operation was completed successfully. There were no complications such as puncture bleeding, infection and skin ulceration after the operation. At 3-month follow-up, based on clinical rating scale for tremor (CRST) the score of essential tremor patient was improved by 43.6%; the UPDRS (unified Parkinson disease rating scale)-Ⅲ scores of 2 Parkinson′s disease patients were improved by 84.9% and 90.5% respectively. \u0000 \u0000 \u0000Conclusion \u0000The remote control of MER in DBS surgery with 5G communication seems to have certain feasibility. \u0000 \u0000 \u0000Key words: \u0000Parkinson disease; Essential tremor; Deep brain stimulation; 5G communication; Remote control surgery","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1200-1204"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48877076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.006
Mengting Xu, Y. Tao, Hai⁃long Jin, S. Gong, Xingwang Yang, Xiao Sun, Yang Liu, Shimiao Wang
Objective To investigate the short-term outcome of deep brain stimulation (DBS) for the treatment of pain associated with PD (Parkinson′s disease). Methods The clinical data of 47 cases of PD patients with pain symptoms admitted to Neurosurgery Department of Northern Theater Command General Hospital from January 2017 to June 2018 were retrospectively analyzed. A total of 35 patients underwent STN (subthalamic nucleus)-DBS and 12 patients underwent GPi (globus pallidus internus)-DBS. The stimulation contact selection and parameter adjustment were carried out at 3 weeks post operation. Visual analogue scale (VAS) was used to evaluate the degree of preoperative and postoperative pain severity. Results The VAS [median (upper and lower quartiles)] were 1.0 (0.5-1.4) and 1.0(0.7-1.6) respectively at 3 months and 6 months post operation in 47 patients, which was statistically different from that of pre-operation 4.0(4.0-8.0) (both P<0.001). At 3 months post operation, the improvement rate of 35 patients undergoing STN-DBS was (79.5±26.3)%, which was not statistically different from that of 12 patients undergoing GPi-DBS [(76.9±28.4)%] (P=0.78). The improvement rate of 35 patients receiving STN-DBS was (75.1±27.4)% 6 months after operation, which was not statistically different from that of 12 patients receiving GPi-DBS [(82.8±28.9)%] (P=0.86). Conclusion Deep brain stimulation could effectively relieve PD-related pain. There seems no significant difference between GPi-DBS and STN-DBS in the treatment outcome of PD-related pain. Key words: Parkinson disease; Pain; Deep brain stimulation; Treatment outcome
{"title":"Short-term effect of deep brain stimulation on pain associated with Parkinson′s disease","authors":"Mengting Xu, Y. Tao, Hai⁃long Jin, S. Gong, Xingwang Yang, Xiao Sun, Yang Liu, Shimiao Wang","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.006","url":null,"abstract":"Objective \u0000To investigate the short-term outcome of deep brain stimulation (DBS) for the treatment of pain associated with PD (Parkinson′s disease). \u0000 \u0000 \u0000Methods \u0000The clinical data of 47 cases of PD patients with pain symptoms admitted to Neurosurgery Department of Northern Theater Command General Hospital from January 2017 to June 2018 were retrospectively analyzed. A total of 35 patients underwent STN (subthalamic nucleus)-DBS and 12 patients underwent GPi (globus pallidus internus)-DBS. The stimulation contact selection and parameter adjustment were carried out at 3 weeks post operation. Visual analogue scale (VAS) was used to evaluate the degree of preoperative and postoperative pain severity. \u0000 \u0000 \u0000Results \u0000The VAS [median (upper and lower quartiles)] were 1.0 (0.5-1.4) and 1.0(0.7-1.6) respectively at 3 months and 6 months post operation in 47 patients, which was statistically different from that of pre-operation 4.0(4.0-8.0) (both P<0.001). At 3 months post operation, the improvement rate of 35 patients undergoing STN-DBS was (79.5±26.3)%, which was not statistically different from that of 12 patients undergoing GPi-DBS [(76.9±28.4)%] (P=0.78). The improvement rate of 35 patients receiving STN-DBS was (75.1±27.4)% 6 months after operation, which was not statistically different from that of 12 patients receiving GPi-DBS [(82.8±28.9)%] (P=0.86). \u0000 \u0000 \u0000Conclusion \u0000Deep brain stimulation could effectively relieve PD-related pain. There seems no significant difference between GPi-DBS and STN-DBS in the treatment outcome of PD-related pain. \u0000 \u0000 \u0000Key words: \u0000Parkinson disease; Pain; Deep brain stimulation; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1216-1220"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48518017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.007
Yingbin Jiao, Yongli Bo, F. Duan, Junhong Wang, Jun Ma, Q. Lin, Zhiyong Yan, Qing-hai Meng
Objective To explore the consistency of neurovascular relationships between multimodal image fusion 3D reconstruction and intraoperative findings in microvascular decompression (MVD) for primary trigeminal neuralgia (PTN). Methods A retrospective analysis was conducted on the clinical data of 50 PTN patients treated with MVD at Department of Neurosurgery, Qingdao University Hospital from January to November 2018. All subjects underwent three-dimensional time-flying magnetic resonance angiography (3D-TOF-MRA) and three-dimensional cyclic phase steady-state acquisition rapid imaging (3D-FIESTA) sequences. Then, the 3D-slicer software was used to reconstruct the multimodal fusion 3D image. Multimodal image fusion 3D reconstruction images and surgical video were analyzed to determine the offending vessels responsible for trigeminal neuralgia. At the same time, the direction of compression, compression site and compression degree of the trigeminal nerve were analyzed. Kappa consistency test method was used to judge the consistency of the two approaches above. Results With MVD set as the standard, the accuracies of multimodal image fusion 3D reconstruction images in determining the offending vessels, direction of compression, compression site and the degree of compression were 92.0% (46/50), 92.0% (46/50), 96.0% (48/50) and 58.0% (29/50), respectively. Multimodal image fusion 3D reconstruction images and MVD showed high consistency in judging offending vessels, compression direction and compression position (Kappa values: 0.729, 0.903 and 0.955 respectively, all P<0.001). However, the consistency was poor in judging the degree of compression of offending vessels to the trigeminal nerve (Kappa value=0.227, P=0.002). The degree of compression was higher in intraoperative findings of MVD than that revealed by multimodal image fusion three-dimensional reconstruction (mean values: 2.57 and 1.58 respectively, Z=-4.499, P<0.001). Conclusions Preoperative multi-modal image fusion 3D reconstruction could help accurately determine the offending vessel, compression direction and compression position of PTN, which seems highly consistent with intraoperative findings of MVD. Preliminary speculation could be used as one of the methods facilitating preoperative diagnosis. Key words: Trigeminal neuralgia; Multimodal image fusion; Microvascular decompression; Neurovascular relationship; Computer-aided diagnosis
{"title":"Consistency of neurovascular relationship between multimodal image fusion 3D reconstruction and intraoperative findings of microvascular decompression for primary trigeminal neuralgia","authors":"Yingbin Jiao, Yongli Bo, F. Duan, Junhong Wang, Jun Ma, Q. Lin, Zhiyong Yan, Qing-hai Meng","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.007","url":null,"abstract":"Objective To explore the consistency of neurovascular relationships between multimodal image fusion 3D reconstruction and intraoperative findings in microvascular decompression (MVD) for primary trigeminal neuralgia (PTN). Methods A retrospective analysis was conducted on the clinical data of 50 PTN patients treated with MVD at Department of Neurosurgery, Qingdao University Hospital from January to November 2018. All subjects underwent three-dimensional time-flying magnetic resonance angiography (3D-TOF-MRA) and three-dimensional cyclic phase steady-state acquisition rapid imaging (3D-FIESTA) sequences. Then, the 3D-slicer software was used to reconstruct the multimodal fusion 3D image. Multimodal image fusion 3D reconstruction images and surgical video were analyzed to determine the offending vessels responsible for trigeminal neuralgia. At the same time, the direction of compression, compression site and compression degree of the trigeminal nerve were analyzed. Kappa consistency test method was used to judge the consistency of the two approaches above. Results With MVD set as the standard, the accuracies of multimodal image fusion 3D reconstruction images in determining the offending vessels, direction of compression, compression site and the degree of compression were 92.0% (46/50), 92.0% (46/50), 96.0% (48/50) and 58.0% (29/50), respectively. Multimodal image fusion 3D reconstruction images and MVD showed high consistency in judging offending vessels, compression direction and compression position (Kappa values: 0.729, 0.903 and 0.955 respectively, all P<0.001). However, the consistency was poor in judging the degree of compression of offending vessels to the trigeminal nerve (Kappa value=0.227, P=0.002). The degree of compression was higher in intraoperative findings of MVD than that revealed by multimodal image fusion three-dimensional reconstruction (mean values: 2.57 and 1.58 respectively, Z=-4.499, P<0.001). Conclusions Preoperative multi-modal image fusion 3D reconstruction could help accurately determine the offending vessel, compression direction and compression position of PTN, which seems highly consistent with intraoperative findings of MVD. Preliminary speculation could be used as one of the methods facilitating preoperative diagnosis. Key words: Trigeminal neuralgia; Multimodal image fusion; Microvascular decompression; Neurovascular relationship; Computer-aided diagnosis","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1221-1225"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44338246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1001-2346.2019.12.005
Lidao Chen, Xiumin Zhang, Pan Nie, Wen Liu, Jibo Zhang, K. Fu, Wenping Xiong, Shiyu Zhao, Jinsong Xiao, J Zhang
Objective To analyze the changes in stimulation parameters post subthalamic nucleus(STN) deep brain stimulation (DBS) for the treatment of Parkinson′s disease. Methods Ninety-five cases of patients with Parkinson′s disease treated with STN-DBS at Department of Neurosurgery, Zhongnan Hospital of Wuhan University from November 2011 to June 2017 were analyzed retrospectively. The stimulation parameters of 95 patients were as follows: the monopolar stimulation was main (98.3%, 175/178), The stimulus contacts were mainly in the upper STN (90.9%, 171/188), and most of them were single contact stimulation (94.4%, 168/178). Patients were evaluated in 3 months, 6 months, 1 year and 2 years. The primary outcome was assessed included the post-operation parameters, the unified Parkinson′s disease rating scale Ⅲ(UPDRS-Ⅲ), the improvement rate[(preoperative score-postoperative score) / preoperative score × 100%], the stimulus energy(voltage2×frequency×pulsewidth/impedance×1 s), the stimulation-related adverse events. Results The electrodes of 95 patients were implanted into preset targets based on intraoperative microelectrode recording and postoperative MRI images.The score of UPDRS-Ⅲ was (12.7 ±6.7)points, which was better than that before operation(P<0.05), and the improvement rate was (70.7±12.1)%. During the follow-up period, the improvement rate of UPDRS-Ⅲ decreased gradually (F=2.421, P=0.048). The voltage increased gradually (F=24.633, P<0.001), the pulse width increased slightly (F=3.118, P=0.015), but the frequency did not change significantly (F=1.332, P=0.257). The energy increased gradually (P<0.05), the contacts in zona incerta (ZI) increased gradually (P<0.05), the bipolar stimulation increased slightly (P<0.05), and the double contacts gradually increased gradually (P<0.05). During the follow-up period, a total of 35 patients developed stimulation-related adverse events, including 14 patients with troublesome dyskinesia, 4 patients with gait disorder or disequilibrium, 1 patients with anxiety and depression, 2 patients with dysphagia or drinking cough, 8 patients with hallucinations, 1 patient with hypophrenia, 2 patients with increased excitability, 1 patient with eye opening difficulty. Conclusions With the passage of time in the treatment of Parkinson′s disease with STN-DBS, the stimulation voltage and energy increased gradually, and the stimulation mode of double contacts increased gradually, but it was still dominated by unipolar stimulation, and the upper part of STN is the best stimulus site. Key words: Parkinson disease; Subthalamic nucleus; Deep brain stimulation; Post-operation programming
{"title":"Programming parameter analysis of subthalamic deep brain stimulation for the treatment of Parkinson′s disease","authors":"Lidao Chen, Xiumin Zhang, Pan Nie, Wen Liu, Jibo Zhang, K. Fu, Wenping Xiong, Shiyu Zhao, Jinsong Xiao, J Zhang","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.005","url":null,"abstract":"Objective \u0000To analyze the changes in stimulation parameters post subthalamic nucleus(STN) deep brain stimulation (DBS) for the treatment of Parkinson′s disease. \u0000 \u0000 \u0000Methods \u0000Ninety-five cases of patients with Parkinson′s disease treated with STN-DBS at Department of Neurosurgery, Zhongnan Hospital of Wuhan University from November 2011 to June 2017 were analyzed retrospectively. The stimulation parameters of 95 patients were as follows: the monopolar stimulation was main (98.3%, 175/178), The stimulus contacts were mainly in the upper STN (90.9%, 171/188), and most of them were single contact stimulation (94.4%, 168/178). Patients were evaluated in 3 months, 6 months, 1 year and 2 years. The primary outcome was assessed included the post-operation parameters, the unified Parkinson′s disease rating scale Ⅲ(UPDRS-Ⅲ), the improvement rate[(preoperative score-postoperative score) / preoperative score × 100%], the stimulus energy(voltage2×frequency×pulsewidth/impedance×1 s), the stimulation-related adverse events. \u0000 \u0000 \u0000Results \u0000The electrodes of 95 patients were implanted into preset targets based on intraoperative microelectrode recording and postoperative MRI images.The score of UPDRS-Ⅲ was (12.7 ±6.7)points, which was better than that before operation(P<0.05), and the improvement rate was (70.7±12.1)%. During the follow-up period, the improvement rate of UPDRS-Ⅲ decreased gradually (F=2.421, P=0.048). The voltage increased gradually (F=24.633, P<0.001), the pulse width increased slightly (F=3.118, P=0.015), but the frequency did not change significantly (F=1.332, P=0.257). The energy increased gradually (P<0.05), the contacts in zona incerta (ZI) increased gradually (P<0.05), the bipolar stimulation increased slightly (P<0.05), and the double contacts gradually increased gradually (P<0.05). During the follow-up period, a total of 35 patients developed stimulation-related adverse events, including 14 patients with troublesome dyskinesia, 4 patients with gait disorder or disequilibrium, 1 patients with anxiety and depression, 2 patients with dysphagia or drinking cough, 8 patients with hallucinations, 1 patient with hypophrenia, 2 patients with increased excitability, 1 patient with eye opening difficulty. \u0000 \u0000 \u0000Conclusions \u0000With the passage of time in the treatment of Parkinson′s disease with STN-DBS, the stimulation voltage and energy increased gradually, and the stimulation mode of double contacts increased gradually, but it was still dominated by unipolar stimulation, and the upper part of STN is the best stimulus site. \u0000 \u0000 \u0000Key words: \u0000Parkinson disease; Subthalamic nucleus; Deep brain stimulation; Post-operation programming","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1210-1215"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42725351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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