Hardware-Related Complications after Placement of Thalamic Deep Brain Stimulator Systems

TLDR

Deep brain stimulation (DBS) has become a common therapeutic approach to patients with movement disorders. The study aims to show that surgical and hardware modifications can reduce complications and to inform surgeons of the spectrum of device‑related problems. The authors evaluated thalamic DBS outcomes in 66 patients from two centers and tailored management to each hardware problem. Among 66 patients, all systems improved tremor but 23 hardware problems (27%) occurred, most commonly extracranial lead breakage, infection, battery/connector issues, lead migration, and hemorrhage.

Abstract

Deep brain stimulation (DBS) has become a common therapeutic approach to patients with movement disorders. We evaluated results from two centers in a large metropolitan area where DBS systems are implanted into the thalamus for patients with tremor. Although all implanted systems led to an improvement in tremor, morbidity related to the hardware system occurred. A total of 23 hardware problems were noted in 66 patients undergoing implantation of 66 DBS systems (27% of patients). The most common problem included breakage of the electrode lead in its extracranial location, system infection, battery or connector problems, lead migration, and hemorrhage. Management was tailored to the specific hardware-related problem. Modifications in both surgical technique and hardware design should reduce the incidence of complications. Surgeons who place DBS systems should be aware of the spectrum of problems that can be associated with the device and its placement.