Surgical Complications of Deep Brain Stimulation

Abstract

BACKGROUND/AIMS: 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. CONCLUSION: Surgeon experience and hardware improvements have significantly reduced complications over time.