Deep Brain Stimulation Hardware Complications in Patients with Movement Disorders: Risk Factors and Clinical Correlations

作者：Carvallo Jose Fidel Baizabal; Mostile Giovanni; Almaguer Mike; Davidson Anthony; Simpson Richard; Jankovic Joseph^*

来源：Stereotactic and Functional Neurosurgery, 2012, 90(5): 300-306.

DOI：10.1159/000338222

• Deep brain stimulation
• Hardware complications
• Parkinson%26apos
• s disease
• Essential tremor
• Dystonia
• Infectious disease

Background: Deep brain stimulation (DBS) has proven to be an effective treatment for Parkinson%26apos;s disease (PD) and other movement disorders, but its usefulness is limited by complications related to the hardware. Methods: We reviewed the records of all our patients treated with DBS from January 1996 to August 2010 and analyzed those with hardware complications and reasons for surgical revision. Results: A total of 512 patients underwent 856 electrode implantations during the study period. A total of 297 (58%) patients had PD, 127 (24.8%) had essential tremor (ET), 40 (7.8%) had dystonia, and 48 (9.37%) had another movement disorder. The mean age at the first electrode implantation was 57.6 +/- 14 years and patients were followed for a mean of 3.9 +/- 2.8 years. A total of 44 patients (8.6%) had a hardware complication or system revision. Lead fracture was the most common complication and occurred in 13 (2.5%) patients, followed by infections (n = 10, 1.9%), electrode misplacement (n = 10, 1.9%), electrode migration (n = 9, 1.75%), and other complications (n = 2, 0.39%). Patients with ET had a higher risk of hardware complications compared to those with PD, 13 vs. 7% (OR 2.03; p = 0.042). Conclusions: DBS is a safe intervention with a relatively low rate of hardware complications.

• 出版日期2012