Deep brain stimulation lead fixation: a comparative study of the Navigus and Medtronic burr hole fixation device

Objectives: To determine the extent of lead movement based on the type of burr hole fixation device used to secure the lead (Image-Guided Neurologics [IGN], Navigus versus Medtronic [Model 7495-51]). A randomized, blinded design of lead movement measurement was used. Methods: A clinical series of 58 individuals undergoing placement of a deep brain stimulation (DBS) system with a total of 71 operative sides were examined. Lead position was compared between 71 paired, sagital, digitized X-rays of lead position immediately before and after the lead was secured to the basecap. Lead movement was measured in a randomized, blinded fashion using the Siemens measurement tool at an 8× magnification rate. The presurgical planned target centered at the cross hatch of the reticules on a lateral X-ray served as the reference point to determine lead movement. Results: The overall mean lead movement was significantly less using the IGN (1.9 mm), as compared to the Medtronic (3.3 mm), fixation device. Moreover, the pattern of lead movement was significantly different between the two devices. That is, the majority of measured movements using IGN device was in the superior direction (74%), whereas the opposite was true for the Medtronic device (i.e., 62% with inferior movement). Conclusion: The IGN burr hole fixation device is associated with significantly less movement when securing the lead. Probable mechanisms of movement are discussed.