| Burr-hole Trephination for Chronic Subdural Hematoma Using the O-arm |
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Chi Hyung Lee , Young Ha Kim , Chang Hyeun Kim , Soon Ki Sung , Dong Wuk Son , Sang Weon Lee , Geun Sung Song |
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Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea |
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| Abstract |
Objective
Chronic subdural hematoma is one of most common conditions requiring operation or management in neurosurgery. It can be easily treated and has a low morbidity and mortality rates. However, especially in elderly patients, recurrence and need for re-operation rate are high. After the introduction of the O-arm surgical imaging system, we discuss the changes in the surgical results and methods in chronic subdural hematoma treatment.
Methods
We retrospectively reviewed 59 consecutive patients who underwent burr-hole trephination for a chronic subdural hematoma in our institution between November 2014 and February 2016. We analyzed their medical records and radiological images. We divided the patients into two groups, one using the O-arm(N=15) and one not using the O-arm(N=44), and compared the surgical outcomes.
Results
Fifty-five patients underwent burr-hole trephination for a chronic subdural hematoma in 59 surgical procedures. The mean patient age was 66.7±13.4 years (range, 22-85 years). Fifteen patients (25.4%) underwent pre- or postoperative O-arm scanning. There were no specific statistical differences in the patient characteristics and surgical outcomes (p>0.05) on comparing the two groups. Although, postoperative complications developed in 3 patients (5.1%) in the group not using the O-arm, the same was not observed in the patients in the group that used the O-arm.
Conclusion
Our experience with burr-hole trephination for chronic subdural hematoma shows that O-arm imaging and StealthStation navigation can help assess the accurate burr-hole location and number, and in deciding whether additional procedure, such as drain catheter reposition. |
| Key Words:
Hematoma, Subdural, Chronic, Postoperative complications, Recurrence, Brain Hemorrhage, Traumatic |
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