Cyanoacrylate Adhesive With Titanium Plate Fixation for Deep Brain Stimulation Leads: A Case Series and Technical Note.

Background and objectives: Deep brain stimulation (DBS) is a highly effective therapeutic intervention for managing neurological disorders, including Parkinson disease. However, conventional lead fixation methods, such as covering devices, often lead to complications, including cranial deformities and electrode migration. The aim of our study was to present a novel technique that integrates n-butyl-2-cyanoacrylate adhesive with a titanium "dog-bone" plate for DBS lead fixation, to enhance both esthetic and functional outcomes.

Methods: A retrospective analysis was conducted on 32 patients with medication-refractory Parkinson disease or parkinsonism who had previously undergone DBS surgery using this fixation technique. The method involved applying n-butyl-2-cyanoacrylate around the lead at the burr-hole site, followed by secondary stabilization with a titanium plate. Intraoperative imaging confirmed lead positioning, and patients were monitored for up to 21.6 months (±10.2) for migration, infection, and esthetic satisfaction.

Results: All 32 patients showed successful lead fixation without cases of migration, displacement, or mechanical failure over the follow-up. No postoperative infections, seizures, or meningitis were reported, indicating a favorable safety profile. The method provided a smooth cranial contour, with high patient satisfaction, especially among those with alopecia or thin skin. In addition, the technique potentially reduced operative time because of the rapid polymerization of the adhesive, thereby minimizing risks associated with prolonged surgeries.

Conclusion: The combination of n-butyl-2-cyanoacrylate and a titanium "dog-bone" plate for DBS lead fixation offers an effective, aesthetically superior, and cost-efficient alternative to conventional methods. The reduced complication rates and enhanced patient satisfaction suggest that this technique may represent a viable future standard for DBS procedures. Further multicenter studies are recommended to validate these findings.