61850 Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical

Name of the Procedure:

Twist Drill or Burr Hole(s) for Implantation of Neurostimulator Electrodes, Cortical

Summary

This procedure involves creating a small opening in the skull to place neurostimulator electrodes on the brain's surface. It's often used to treat neurological conditions by delivering electrical impulses directly to the brain.

Purpose

This procedure is aimed at treating severe neurological conditions such as chronic pain, movement disorders (like Parkinson's disease), and epilepsy. By implanting neurostimulator electrodes, the brain's abnormal activity can be regulated, potentially alleviating symptoms and improving quality of life.

Indications

• Chronic pain management
• Movement disorders (e.g., Parkinson's disease, dystonia)
• Epileptic seizures
• Patients unresponsive to medication or other less invasive treatments

Preparation

• Fasting for a specified period before the procedure
• Temporary cessation or adjustment of certain medications
• Preoperative diagnostic tests, such as brain imaging (MRI or CT scans)
• Blood tests to check overall health status

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: A small incision is made in the scalp.
3. Burr Hole: A burr hole is drilled into the skull using a specialized drill to access the brain's surface.
4. Electrode Placement: Neurostimulator electrodes are carefully placed on the cortical surface.
5. Connection: Electrodes are connected to an external neurostimulator device initially, or an internal device if a permanent implant is planned.
6. Closure: The incision is closed with sutures or staples.

Duration

The procedure typically takes about 2 to 4 hours, depending on the complexity and specific patient circumstances.

Setting

This procedure is performed in a hospital operating room equipped with specialized surgical equipment and neurosurgical staff.

Personnel

• Neurosurgeon
• Surgical nurse(s)
• Anesthesiologist
• Operating room technicians

Risks and Complications

• Infection
• Bleeding or hematoma
• Swelling of the brain
• Neurological deficits (e.g., speech or motor impairments)
• Equipment malfunction or displacement of the electrode
• Anesthesia-related complications

Benefits

• Significant reduction in symptoms of the underlying neurological condition
• Potential to improve quality of life
• Reduced dependency on medication
• Immediate or gradual symptom relief post-activation of the neurostimulator

Recovery

• Close monitoring in a hospital for 24-48 hours
• Pain management with prescribed medications
• Instructions to keep the surgical site clean and dry
• Follow-up appointments for programming and adjusting the neurostimulator
• Gradual return to normal activities as supervised by the healthcare team

Alternatives

• Medication management
• Non-invasive neurostimulation techniques
• Surgical interventions such as deep brain stimulation (DBS)
• Lifestyle modifications and physical therapy

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel anything. Afterward, there may be some discomfort at the incision site, managed with pain medication. Most patients might experience some swelling or sensitivity but should progressively notice symptom improvement following neurostimulator activation and adjustment.

This comprehensive guide provides an in-depth look into the twist drill or burr hole procedure for the implantation of neurostimulator electrodes, cortical, ensuring patients are well-informed and prepared.