Long-term surgical and hardware-related complications of deep brain stimulation

Stereotact Funct Neurosurg. 2011;89(2):89-95. doi: 10.1159/000323372. Epub 2011 Feb 2.


Objective: To evaluate the incidence of surgical and hardware-associated complications of deep brain stimulation (DBS) for a range of movement disorders.

Methods: The study design is a retrospective analysis and review of surgical and hardware complications of DBS performed by a single surgeon from 1999 to 2009. A total of 153 cases of DBS (298 electrodes) for various movement disorders and a minimum follow-up of 1 year have been included. Two patients could not be implanted. A further 54 patients who underwent change of the implantable pulse generator (IPG) have been included for analysis of hardware-related complications.

Results: The mean follow-up was 64 ± 36.15 (range = 12-129) months for the DBS group. Twenty-four (15.6%) patients developed complications. Confusion occurred in 3.9%, vasovagal attack in 1.9%, lead migration/misplaced lead in 2.5%, erosion and infection in 4.5% and IPG malfunction occurred in 1.4% of the patients. When calculated with respect to the number of electrodes and IPG replacements, the complication rate was lower (11.9%). Three patients had their system explanted, two of them being patients with dystonia who had inadvertently damaged their operative site.

Conclusion: DBS surgery is a relatively safe surgery, with most of the complications being minor, without long-term morbidity. The complication rate in elderly (age ≥65 years) is comparable to that in younger patients. However, confusion is more frequent in this age group, and patients and relatives can be prepared to accept this as a transient morbidity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Confusion / epidemiology
  • Deep Brain Stimulation / adverse effects*
  • Deep Brain Stimulation / instrumentation
  • Deep Brain Stimulation / methods
  • Equipment Failure
  • Female
  • Foreign-Body Migration / epidemiology
  • Humans
  • Implantable Neurostimulators / adverse effects*
  • Incidence
  • Intraoperative Complications / epidemiology*
  • Male
  • Middle Aged
  • Movement Disorders / therapy*
  • Neurosurgical Procedures / adverse effects*
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods
  • Retrospective Studies
  • Surgical Wound Infection / epidemiology
  • Time Factors
  • Young Adult