Objective: To describe the obstacles to Deep Brain Stimulation (DBS) surgery and analyse the surgical and hardware complications following DBS, the study reports on 25 years of experience from a tertiary care centre.

Background: DBS is the standard of care for advanced Parkinson’s disease.It has its own set of risks and complications. This study from a single centre analyses various risk factors for complications and tries to establish if there is a learning curve effect in minimizing the complications.

Method: A retrospective, single centre, observational study of all patients who underwent DBS surgery or IPG replacement, between the years 1999 and 2023 was performed. Perioperative and hardware related complications were evaluated

Results: Of the 300 total patients, 20 had complications, with mean age of surgery was 56.5 yrs, 66% males. The mean age of onset of Parkinsonism was 46.7 years who underwent DBS at average of 10.67(SD-4.1)years after symptom onset, post-op follow-up period ranged from six months to 25 years.

Surgery-related complications occurred in cases which included confusion in 20% and intracerebral haemorrhage in 3%. Complications related to the DBS hardware were found in 6.6% patients and 2.1% of surgeries. In cases of infection, 3 % of patients had either partial or complete removal of hardware.

The complications were analyzed for every 100 DBS procedures. There was a significant drop in the percentage of complications in from  9% in the first 100 cases to 2% in the last 100 cases (p < 0.0001).

Conclusion: Infection was the most common postoperative complication. Erosion and infection of the surgical site represents the most frequent hardware complication. DBS surgery is safe and the complication rates are acceptably low. The complication rate also decreases with cumulative years of experience, demonstrating a learning curve effect.

References: .

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-surgery-hurdles-and-maladies/