Estimating the Risk of Deep Brain Stimulation in the Modern Era: 2008 to 2020.

Complication Deep brain stimulation Movement disorder Postoperative

Journal

Operative neurosurgery (Hagerstown, Md.)
ISSN: 2332-4260
Titre abrégé: Oper Neurosurg (Hagerstown)
Pays: United States
ID NLM: 101635417

Informations de publication

Date de publication:
13 10 2021
Historique:
received: 26 10 2020
accepted: 16 05 2021
pubmed: 16 8 2021
medline: 16 11 2021
entrez: 15 8 2021
Statut: ppublish

Résumé

Deep brain stimulation (DBS) was first approved by the United States Food and Drug Administration in 1997. Although the fundamentals of DBS remain the same, hardware, software, and imaging have evolved significantly. To test our hypothesis that the aggregate complication rate in the medical literature in the past 12 years would be lower than what is often cited based on early experience with DBS surgery. PubMed, PsycINFO, and EMBASE were queried for studies from 2008 to 2020 that included patients treated with DBS from 2007 to 2019. This yielded 34 articles that evaluated all complications of DBS surgery, totaling 2249 patients. The overall complication rate in this study was 16.7% per patient. There was found to be a systemic complication rate of 0.89%, intracranial complication rate of 2.7%, neurological complication rate of 4.6%, hardware complication rate of 2.2%, and surgical site complication rate of 3.4%. The infection and erosion rate was 3.0%. This review suggests that surgical complication rates have decreased since the first decade after DBS was first FDA approved. Understanding how to minimize complications from the inception of a technique should receive more attention.

Sections du résumé

BACKGROUND
Deep brain stimulation (DBS) was first approved by the United States Food and Drug Administration in 1997. Although the fundamentals of DBS remain the same, hardware, software, and imaging have evolved significantly.
OBJECTIVE
To test our hypothesis that the aggregate complication rate in the medical literature in the past 12 years would be lower than what is often cited based on early experience with DBS surgery.
METHODS
PubMed, PsycINFO, and EMBASE were queried for studies from 2008 to 2020 that included patients treated with DBS from 2007 to 2019. This yielded 34 articles that evaluated all complications of DBS surgery, totaling 2249 patients.
RESULTS
The overall complication rate in this study was 16.7% per patient. There was found to be a systemic complication rate of 0.89%, intracranial complication rate of 2.7%, neurological complication rate of 4.6%, hardware complication rate of 2.2%, and surgical site complication rate of 3.4%. The infection and erosion rate was 3.0%.
CONCLUSION
This review suggests that surgical complication rates have decreased since the first decade after DBS was first FDA approved. Understanding how to minimize complications from the inception of a technique should receive more attention.

Identifiants

pubmed: 34392372
pii: 6352565
doi: 10.1093/ons/opab261
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

277-290

Informations de copyright

© Congress of Neurological Surgeons 2021.

Auteurs

Eun Jeong Koh (EJ)

Department of Neurosurgery, Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea.

Joshua L Golubovsky (JL)

Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.

Richard Rammo (R)

Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA.

Arbaz Momin (A)

Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.

Benjamin Walter (B)

Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA.

Hubert H Fernandez (HH)

Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA.

Andre Machado (A)

Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA.

Sean J Nagel (SJ)

Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA.

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