Paresh K Doshi1. 1. In-charge Stereotactic and Functional Neurosurgical Program, Jaslok Hospital and Research Centre, Mumbai, India. pareshkd@gmail.com
Abstract
OBJECTIVE: To evaluate the incidence of surgical and hardware-associated complications of deep brain stimulation (DBS) for a range of movement disorders. METHODS: The study design is a retrospective analysis and review of surgical and hardware complications of DBS performed by a single surgeon from 1999 to 2009. A total of 153 cases of DBS (298 electrodes) for various movement disorders and a minimum follow-up of 1 year have been included. Two patients could not be implanted. A further 54 patients who underwent change of the implantable pulse generator (IPG) have been included for analysis of hardware-related complications. RESULTS: The mean follow-up was 64 ± 36.15 (range = 12-129) months for the DBS group. Twenty-four (15.6%) patients developed complications. Confusion occurred in 3.9%, vasovagal attack in 1.9%, lead migration/misplaced lead in 2.5%, erosion and infection in 4.5% and IPG malfunction occurred in 1.4% of the patients. When calculated with respect to the number of electrodes and IPG replacements, the complication rate was lower (11.9%). Three patients had their system explanted, two of them being patients with dystonia who had inadvertently damaged their operative site. CONCLUSION: DBS surgery is a relatively safe surgery, with most of the complications being minor, without long-term morbidity. The complication rate in elderly (age ≥65 years) is comparable to that in younger patients. However, confusion is more frequent in this age group, and patients and relatives can be prepared to accept this as a transient morbidity.
OBJECTIVE: To evaluate the incidence of surgical and hardware-associated complications of deep brain stimulation (DBS) for a range of movement disorders. METHODS: The study design is a retrospective analysis and review of surgical and hardware complications of DBS performed by a single surgeon from 1999 to 2009. A total of 153 cases of DBS (298 electrodes) for various movement disorders and a minimum follow-up of 1 year have been included. Two patients could not be implanted. A further 54 patients who underwent change of the implantable pulse generator (IPG) have been included for analysis of hardware-related complications. RESULTS: The mean follow-up was 64 ± 36.15 (range = 12-129) months for the DBS group. Twenty-four (15.6%) patients developed complications. Confusion occurred in 3.9%, vasovagal attack in 1.9%, lead migration/misplaced lead in 2.5%, erosion and infection in 4.5% and IPG malfunction occurred in 1.4% of the patients. When calculated with respect to the number of electrodes and IPG replacements, the complication rate was lower (11.9%). Three patients had their system explanted, two of them being patients with dystonia who had inadvertently damaged their operative site. CONCLUSION: DBS surgery is a relatively safe surgery, with most of the complications being minor, without long-term morbidity. The complication rate in elderly (age ≥65 years) is comparable to that in younger patients. However, confusion is more frequent in this age group, and patients and relatives can be prepared to accept this as a transient morbidity.
Authors: Kingsley O Abode-Iyamah; Hsiu-Yin Chiang; Royce W Woodroffe; Brian Park; Francis J Jareczek; Yasunori Nagahama; Nolan Winslow; Loreen A Herwaldt; Jeremy D W Greenlee Journal: J Neurosurg Date: 2018-03-01 Impact factor: 5.115
Authors: Thomas E Schlaepfer; Bettina H Bewernick; Sarah Kayser; Rene Hurlemann; Volker A Coenen Journal: Neuropsychopharmacology Date: 2014-02-11 Impact factor: 7.853
Authors: Ronald J Triolo; Stephanie Nogan Bailey; Kevin M Foglyano; Rudi Kobetic; Lisa M Lombardo; Michael E Miller; Gilles Pinault Journal: Arch Phys Med Rehabil Date: 2017-09-09 Impact factor: 4.060