Abstract Introduction Frame-based stereotactic techniques have long been considered the gold standard for deep brain stimulation (DBS) electrode implantation. However, advances in neuronavigation have led to the increasing use of Nexframe DBS, which may offer advantages in operative workflow and patient comfort. This study aimed to compare the accuracy, operative efficiency, and safety of Nexframe versus frame-based DBS implantation in a single neurosurgical center. Materials and methods We conducted a retrospective single-center observational study including 121 consecutive patients who underwent DBS surgery between January 2014 and January 2025. Patients were divided into two groups according to the implantation technique: frame-based DBS ( n = 78) and Nexframe DBS ( n = 43). Targeting accuracy was assessed by fusion of preoperative magnetic resonance imaging with postoperative computed tomography. Operative time and postoperative complications were recorded and compared between groups. Results Nexframe DBS implantation demonstrated higher targeting accuracy compared to the frame-based technique ( 94.35 ± 1.17% vs. 91.97 ± 2.68%, p < 0.001 ) and a significantly lower mean targeting error (1.46 ± 0.03 mm vs. 1.81 ± 0.09 mm, p < 0.001). Operative time was shorter in the Nexframe group (3.54 ± 0.13 h vs. 5.51 ± 0.23 h, p < 0.001). Postoperative complications were infrequent in both groups, with no statistically significant difference in overall complication rates (4.7% vs. 7.7%, p = 0.18). Conclusion Nexframe DBS implantation is a safe and effective alternative to frame-based stereotaxy, offering targeting accuracy, shorter operative times without increasing complication rates. These findings support the broader adoption of Nexframe techniques in contemporary DBS surgery.
Magočová et al. (Mon,) studied this question.