Surgical and hardware complications of deep brain stimulation. A seven-year experience and review of the literature.
OBJECTIVE
Deep brain stimulation (DBS) has been established as a safe and efficient method for the treatment of various movement disorders. As the emerging applications continue to expand and more centers become eligible for the procedure, complication rates and complication avoidance become increasingly important. Our aim was to report the DBS-related complication in our department over the last 7 years, compare our rates with those reported in the literature, and highlight those practices that will aid complications avoidance.


METHODS
Since 2003, 106 patients underwent DBS for various pathologies in our department. There were 38 (36%) females and 68 (64%) males with a mean age of 57 years. Preoperative diagnoses included Parkinson's disease (n = 88), dystonia (n = 12), tremor (n = 3), epilepsy (n = 1), obsessive-compulsive disorder (n = 1), and central pain syndrome (n = 1). Surgical and hardware-related complications, their treatment, and outcome were recorded and compared with those reported in the literature.


RESULTS
There were 12 procedure-related complications (11.3% of patients, 5.7% of the procedures). These included death (n = 1), aborted procedure (n = 1), postoperative respiratory distress (n = 3), intracranial hemorrhage (n = 2), epilepsy (n = 1), postoperative confusion or agitation (n = 3), and malignant neuroleptic syndrome (n = 1). Hardware-related complications presented in 4.3% of the procedures and included infection (five patients, 4.7%), electrode breakage (0.94%), lead migration or misplacement (0.94%), and stricture formation (two patients, 1.9%).


CONCLUSIONS
Complication rates after DBS surgery remain low, proving that DBS is not only effective but also safe. Certain strategies do exist in order to minimize complications.
Boviatsis
Efstathios J
EJ
Department of Neurosurgery, Evangelismos General Hospital, Athens, Greece.
Stavrinou
Lampis C
LC
Themistocleous
Marios
M
Kouyialis
Andreas T
AT
Sakas
Damianos E
DE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D004567:Electrodes, Implanted / Q000009:adverse effects* / Q000592:standards; D005260:Female; D006115:Greece / Q000453:epidemiology; D006784:Hospitals, Teaching / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011183:Postoperative Complications / Q000145:classification / Q000401:mortality*; D012189:Retrospective Studies; D055815:Young Adult