Long-Term Surgical and Hardware-Related Complications of Deep Brain Stimulation

@article{Doshi2011LongTermSA,
  title={Long-Term Surgical and Hardware-Related Complications of Deep Brain Stimulation},
  author={Paresh K Doshi},
  journal={Stereotactic and Functional Neurosurgery},
  year={2011},
  volume={89},
  pages={89 - 95}
}
  • P. Doshi
  • Published 2011
  • Medicine
  • Stereotactic and Functional Neurosurgery
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… Expand
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92 Citations
Highly Influential Citations
3
Background Citations
21
Methods Citations
1
Results Citations
3

Paper Mentions

Interventional Clinical Trial
Intrawound Vancomycin Prophylaxis for Neural Stimulator
The implantable pulse generator (IPG) is a device that generates electrical current to stimulate the spine, heart, or brain for various chronic conditions. In neurosurgery, the IPG… Expand
ConditionsDeep Brain Stimulation, Implantable Neural Stimulator, Surgical Site Infection, (+1 more)
InterventionDrug
University of British Columbia
September 2017 - December 2021

92 Citations

Citation Type

Citation Type

Surgical and Hardware Complications of Deep Brain Stimulation-A Single Surgeon Experience of 519 Cases Over 20 Years.
TLDR
Erosion and infection of the surgical site represents the most frequent hardware complication and the complication rate also decreases with cumulative years of experience, demonstrating a learning curve effect. Expand
Experience Reduces Surgical and Hardware-Related Complications of Deep Brain Stimulation Surgery: A Single-Center Study of 181 Patients Operated in Six Years
TLDR
The rates of both early and late complications of DBS surgery are acceptably low and decrease significantly with cumulative experience. Expand
Delayed complications of deep brain stimulation: 16-year experience in 249 patients
TLDR
In case of infection, conservative treatment or partial removal of the DBS system appears to be safe and reasonable, and intracranial complications related to DBS material such as peri-lead edema and cyst formation have a good prognosis. Expand
Systematic review of hardware-related complications of Deep Brain Stimulation: Do new indications pose an increased risk?
TLDR
The authors' analysis identified a variety of potential hardware-related complications among patients who underwent DBS procedures, and patients who were at risk of complications, such as patients with dystonia and off-label indications (e.g. Tourette's syndrome) should be informed prior to surgery and closely followed thereafter. Expand
Deep Brain Stimulation Hardware Complications in Patients with Movement Disorders: Risk Factors and Clinical Correlations
TLDR
DBS is a safe intervention with a relatively low rate of hardware complications, but its usefulness is limited by complications related to the hardware. Expand
The Factors Involved in Deep Brain Stimulation Infection: A Large Case Series
TLDR
The 30-day infection rate in the DBS cases reviewed was comparably low to other published studies, and several factors were noted to be significant in the cumulative infection group, but none in the 30- day infection group. Expand
The safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease
TLDR
Although prophylactic antibiotics and steroids or antihistamine drugs may reduce the risk of infection, it is imperative to identify high-risk patients for whom a therapeutic approach not requiring an implantable device is more suitable, for example, pallidotomy and potentially transcranial ultrasound. Expand
Deep brain stimulation hardware-related infections: 10-year experience at a single institution.
TLDR
It is suggested that intrawound VP may help to reduce the SSI risk after DBS implantation, and continued follow-up for at least 1 year after such a procedure is prudent to establish the true burden of these infections and to properly treat them when they do occur. Expand
Single-Stage Deep Brain Stimulator Placement for Movement Disorders: A Case Series
TLDR
The body of evidence suggesting placement of a complete DBS system during a single procedure appears to be an efficacious and well-tolerated option is expanded. Expand
Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact
TLDR
It is hypothesized that a change in surgical technique and a more effective lead fixation device might mitigate the problem of lead migration in cases with lead migration. Expand
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References

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Long-term Hardware-related Complications of Deep Brain Stimulation
TLDR
Long-term follow-up reveals that hardware-related complications occur in a significant number of patients with DBS, and factors that lead to such complications must be identified and addressed to maximize the important benefits of DBS therapy. Expand
Hardware-related complications of deep brain stimulation: a ten year experience
TLDR
Increased experience and adaptation of surgical technique are the main determinants for avoidance of hardware-related complications in patients with deep brain stimulation (DBS), over a long period of time. Expand
Deep-brain stimulation: long-term analysis of complications caused by hardware and surgery—experiences from a single centre
TLDR
Stereotactic implantation of electrodes for DBS, if performed with multiplanar three-dimensional imaging and advanced treatment planning software, is a safe procedure with no mortality and low morbidity. Expand
Avoidance and Management of Surgical and Hardware-Related Complications of Deep Brain Stimulation
TLDR
Confusion is the most common complication in simultaneous bilateral DBS targeting the subthalamic nucleus, especially in patients with severe Parkinson’s disease, and with increasing experience of surgeons, complete obedience to intraoperative surgical routines and reasonable application of the microelectrode recording technique, other complications could be reduced. Expand
Surgical and hardware complications of subthalamic stimulation
TLDR
Serious complications leading to permanent neurologic deficit are rare after STN DBS for advanced PD, however, long-term follow-up demonstrated that hardware complications are relatively common, having occurred in approximately 26% of these patients. Expand
Hardware-Related Complications after Placement of Thalamic Deep Brain Stimulator Systems
TLDR
Although all implanted systems led to an improvement in tremor, morbidity related to the hardware system occurred and surgeons who place DBS systems should be aware of the spectrum of problems that can be associated with the device and its placement. Expand
Complications of deep brain stimulation: a collective review.
TLDR
DBS is, on the one hand, an effective surgical treatment for movement disorders, but on the other hand, it is a complication-prone operation. Expand
Deep brain stimulation for movement disorders: morbidity and mortality in 109 patients.
TLDR
There is a significant incidence of adverse events associated with the DBS procedure and DBS is clinically effective in well-selected patients and should be seriously considered as a treatment option for patients with medically refractory movement disorders. Expand
Short-term and long-term safety of deep brain stimulation in the treatment of movement disorders.
TLDR
DBS has proven to be safe for the treatment of medically refractory movement disorders in a large population of patients with a variety of movement disorders. Expand
Complications of Deep Brain Stimulation Surgery
TLDR
Although technological advances have reduced device-related complications, DBS surgery still carries a significant risk of transient and permanent complications, and it is important to extend the informed consent to include all potential complications. Expand
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