背景:在某些临床情况下,使用锚定螺栓将电极固定到颅骨上可能很困难。在这里,我们提出了一种无螺栓技术,使用尼龙缝线将电极固定到头皮上,以克服与锚定螺栓相关的问题。我们调查了安全性,精度误差,以及影响无螺栓技术错误的患者相关和手术因素。
方法:这个单机构回顾性系列分析了放置在12名患者中的103个电极。目标点定位误差(TPLE),入口点定位错误(EPLE),径向误差(RE),计算电极的深度误差(DE)。
结果:每个电极的平均手术时间的中位数为9.3分钟。TPLE中位数,EPLE,RE,绝对DE值为4.1mm,1.6mm,2.7mm,和1.9毫米,分别。术前头皮厚度呈正相关,每个电极的平均手术时间,EPLE,RE,以及DE与TPLE的绝对值(分别为r=.228,p=.02;r=.678,p=.015;r=.228,p=.02;r=.445,p<.01;r=.630,p<.01),和电极接近角相对于EPLE(r=.213,p=.031)。多变量分析表明,DE的绝对值对TPLE的影响最强,其次是RE和术前头皮厚度,分别(β=.938、.544、.060,p<.001)。没有遇到与SEEG插入和监测相关的并发症。
结论:使用我们独特的计划和技术方法的无螺栓技术是一种安全的,有效,和低成本替代的情况下,锚杆是禁忌的。
BACKGROUND: The use of anchor bolts to secure electrodes to the skull can be difficult in some clinical situations. Herein, we present the boltless technique to secure electrodes to the scalp using nylon sutures to overcome the problems associated with anchor bolts. We investigated the safety, accuracy errors, and patient-related and operative factors affecting errors in the boltless technique.
METHODS: This single-institution retrospective series analyzed 103 electrodes placed in 12 patients. The target-point localization error (TPLE), entry-point localization error (EPLE), radial error (RE), and depth error (DE) of the electrodes were calculated.
RESULTS: The median of the mean operative time per electrode was 9.3 min. The median TPLE, EPLE, RE, and absolute DE value were 4.1 mm, 1.6 mm, 2.7 mm, and 1.9 mm, respectively. Positive correlations were observed between the preoperative scalp thickness, mean operative time per electrode, EPLE, RE, and the absolute value of DE versus TPLE (r = .228, p = .02; r = .678, p = .015; r = .228, p = .02; r = .445, p < .01; r = .630, p < .01, respectively), and electrode approach angle versus EPLE (r = .213, p = .031). Multivariate analysis revealed that the absolute value of DE had the strongest influence on the TPLE, followed by RE and preoperative scalp thickness, respectively (β = .938, .544, .060, respectively, p < .001). No complications related to SEEG insertion and monitoring were encountered.
CONCLUSIONS: The boltless technique using our unique planning and technical method is a safe, effective, and low-cost alternative in cases where anchor bolts are contraindicated.