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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Long-term hardware‐related complications of deep‐brain stimulation in a large cohort of 586 surgeries – more frequent in Tourette and dystonia

Stimulationssystem bezogene Komplikationen bei Tiefenhirnstimulation an einem großen Patientenkollektiv von 586 Operationen im Langzeit-Follow-up – häufigeres Auftreten bei Tourette und Dystonie

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  • presenting/speaker Joachim Runge - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Assel Saryyeva - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Marc Wolf - Universitätsklinikum Mannheim, Neurologie, Mannheim, Deutschland
  • Christian Blahak - Universitätsklinikum Mannheim, Neurologie, Mannheim, Deutschland
  • Christoph Schrader - Medizinische Hochschule Hannover, Neurologie, Hannover, Deutschland
  • Thomas M. Kinfe - Universitätsklinikum Bonn, Neurochirurgie, Bonn, Deutschland
  • Hansjörg Bäzner - Universitätsklinikum Mannheim, Neurologie, Mannheim, Deutschland
  • Mahmoud Abdallat - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Joachim K. Krauss - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP206

doi: 10.3205/20dgnc492, urn:nbn:de:0183-20dgnc4926

Published: June 26, 2020

© 2020 Runge et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: In this retrospective study we determined the frequency of hardware‐related complications of deep brain stimulation in a large series of patients.

Methods: 586 surgeries for DBS electrode implantation were performed from 1997 to 2018. All procedures were performed or supervised by the same neurosurgeon in three different centers using the same technique. The median follow-up was 3.7 years with the longest follow up of 16.9 years. Hardware-related complications within this time were documented and analysed.

Results: In 27 cases (4.5%) we could detect hardware complications. There were 11 lead fractures which in reimplantation of the leads in 10 cases, while one patient refused to undergo another surgery. Three of these patients had fractures of both leads. Fifteen patients had fractures in the extension cables connecting the lead with the implanted pulse generator (IPG). Malfunction of the IPG resulted in IPG replacement before battery depletion in one case. These complications became manifest between 1 month and 6.4 years after surgery, at a mean of 3.7 years. We found a significantly higher rate of fractures (lead and extension) in patients with Tourette syndrome (21.3 % of Tourette-patients, p=0.007). Also patients with dystonia got a significantly higher concurrency of lead fractures (3.7%, p=0,043).

Conclusion: Sustained or repetitive muscle contractions in dystonic patients or motor tics in patients with Tourette syndrome cause a higher physical exposure for DBS hardware resulting in a higher rate of fractures.