Article
Surgical complications of Deep Brain Stimulation Surgery (DBS)
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Published: | June 4, 2012 |
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Objective: Despite optimal neurosurgical care for patients undergoing DBS and excellent clinical results, a number of complications need to be dealt with. Therefore the identification of risk factors and especially prone patient groups is essential.
Methods: We retrospectively analyzed risk factors like preexisting disorders and complications in all patients, who had consecutively undergone DBS in our department from the first surgical procedure in 1999 until now.
Results: Looking at the perioperative complications of the 612 patients (age 5 to 83 years, mean age 55,8 years), hemorrhage occurred in 15 patients, 10 of which were asymptomatic, 2 had a transient and 1 a permanent hemiparesis and 2 patients died. 6 postoperative MRI-scans showed local infarction, in one case with a transient hemiparesis. 2 patients died due to unrelated complications. Two dislocated electrodes had to be revised. The overall the perioperative complication rate was 4,4% with a permanent morbidity of 0,3% and a mortality of 0,6%. As late onset complications, skin complications appeared in 19 patients (3,2%, 1 to 48 months after surgery), painful scaring or dislocation of the generator in 20 patients, 3 patients had to be revised due to defects of the hardware. No single risk factors for hemorrhage or skin complications could be found.
Conclusions: Overall DBS is a safe surgical procedure with an acceptable complication rate. Skin and hardware related complications are the major long-term problem following DBS. Long-term teaching and surgical contact with the patients helps to avoid complications early. No special risk factors could be detected. Therefore the indication for surgery and the benefit/risk consideration needs individual evaluation.