Surgical complications of deep brain stimulation. A longitudinal single surgeon, single institution study.
OBJECTIVE
Deep brain stimulation is a commonly performed procedure for intractable movement disorders. In this report we analyze the complications of a single surgeon at one institution over a 10-year period.


METHODS
A total of 191 patients received 330 electrode implants. Data was collected prospectively and analyzed retrospectively for the type and rate of complications.


RESULTS
The mean follow-up was 58.5 months. The overall surgical complication rate was 17.8% (59 complications in 330 implantations). These 59 complications involved 53 of 191 patients. The overall incidence of minor wound problems (hardware not removed), major wound problems (hardware removed) and hardware-related problems was 4.2% each, based on the total number of systems implanted. In addition 2.1% of the patients suffered minor bleeds while 1.6% had bleeds large enough to cause neurological deficits. The same percentage of patients (1.6%) either failed to benefit from the procedure or suffered complications unrelated to the procedure. A further 4/191 (2.1%) patients had neurological deficits without obvious hemorrhage on postoperative nonenhanced computerized tomography. Analysis of our complications from year to year shows a declining complication rate related to accumulated experience and better hardware design.


CONCLUSIONS
Surgeon experience and hardware improvements have significantly reduced complications over time.
Bhatia
Sanjay
S
Department of Neurosurgery, Allegheny General Hospital, Pittsburgh, PA 15212, USA.
Oh
Michael
M
Whiting
Taylor
T
Quigley
Matthew
M
Whiting
Donald
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006769:Hospitals, General / Q000379:methods / Q000639:trends; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult