Approach for tunneling the lead in deep brain stimulation

The implantation of a deep brain stimulator (DBS) is often a staged procedure that involves stereotactic placement of the neurostimulator electrode, followed by connection of the electrode to a pulse generator during a separate operation. The authors describe a practical technique for the retrograde tunneling of the stimulator lead during the initial electrode implantation procedure. After DBS electrode placement and securing of the lead, the lead is covered with a protective cap and boot, which are then folded back to tunnel a redundant loop of the lead in a retrograde fashion into a subgaleal pocket. This technique facilitates connection of the lead to the pulse generator connecting wire at the subsequent operation and may reduce lead damage. (DOI: 10.3171/2009.6.JNS09554)