Modified Cement-Based Fixation of the Deep Brain Stimulation Electrode

After having determined the optimal implantation site during DBS surgery, the microelectrode recording/test stimulation electrode is removed and fluoroscopy is performed.Then, the final DBS electrode is lowered to the optimal stimulation site.After placing two layers of oxidized cellulose polymer (Surgicel ® ), one or two titanium screws (2 × 5 mm, the size might depend on individual preferences) are placed close to the burr hole and the acrylic is applied.Finally, the internal guide is removed, a second layer of acrylic is used to fix the electrode.We have performed 8 surgeries (16 electrode fixations) with this method and have not observed any movements of the acrylic construct related to cerebrospinal fluid/parenchyma pulsations.The construction was extremely solid.This was independent of whether one or two screws were used.Adequate fixation of the DBS electrode is essential to prevent postoperative migration.The acrylic-based fixation method has been our method of choice for the last 15 years for several reasons.We modified this method by adding anchoring screws to increase the robustness.This change is in line with other attempts in the field to improve DBS surgery.