Clinical Improvement in Deep Brain Stimulation with the Use of the O-Arm.

The O-arm surgical imaging system® is a multidimensional platform that provides the opportunity of visualizing the electrodes in real time in deep brain stimulation surgery. The objective of this study is to investigate in our center the value of this tool, by comparing the clinical improvement of a group operated on with this technology and a control group. After one year follow-up, the results were analyzed. Material and Methods: Twenty consecutive Parkinson disease patients that received deep brain stimulation with one year follow-up were selected. Electrode placement was optimized using the O-arm imaging system. They were compared to 20 consecutive patients operated on under 2D fluoroscopy as a control group. In both groups variation of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS-III) was measured, in addition to the number of microrecording tracks and the length of the surgery. Results: A median basal off reduction of 42% was observed in the O-arm group vs. 24% in the control at one year follow-up, which was statistically significant (p < 0.005). The reduction of the length of the surgery was statistically significant, being 1 h and 10 minutes less in the O-arm group. The number of tracks needed per electrode was reduced from 2.47 to 1.99. Conclusions: The O-arm can be easily included in the workflow of deep brain stimulation surgery. It gives the opportunity of visualizing the electrodes in real time. In our center it has helped to improve our results and refine our procedure. It has helped reducing the surgical time and number of tracks, as well as improving the clinical state of our patients. Further studies are needed to establish the fusion error. [ABSTRACT FROM AUTHOR]