Hardware-related infections after deep brain stimulation surgery: review of incidence, severity and management in 212 single-center procedures in the first year after implantation

Acta Neurochir (Wien). 2011 Dec;153(12):2337-41. doi: 10.1007/s00701-011-1130-2. Epub 2011 Aug 27.

Abstract

Background: Device-related infection is a common occurrence after deep brain stimulation (DBS) surgery, and may result in additional interventions and a loss of efficacy of therapy. This retrospective review aimed to evaluate the incidence, severity and management of device-related infections in 212 DBS procedures performed in our institute.

Methods: Data on 106 patients, in whom 212 DBS procedures were performed between 2001 and 2011 at our institute by a single neurosurgeon (M.P.), were reviewed to assess the incidence, severity, management and clinical characteristics of infections in the first year after the implantation of a DBS system.

Results: Infections occurred in 8.5% of patients and 4.2% of procedures. Of the nine infections, eight involved the neurostimulator and extensions, and one the whole system. The infections occurred 30.7 days after implantation: 7 within 30 days and 2 within 6 months. Infected and uninfected patients were comparable in terms of age, sex, indication for DBS implantation and neurostimulator location. In eight cases, the system components involved were removed and re-implanted after 3 months, while in one case the complete hardware was removed and not re-implanted.

Conclusion: The overall incidence of postoperative infections after DBS system implantation was 4.2%; this rate decreased over time. All infections required further surgery. Correct and timely management of partial infections may result in successful salvage of part of the system.

Publication types

  • Review

MeSH terms

  • Aged
  • Central Nervous System Bacterial Infections / epidemiology*
  • Central Nervous System Bacterial Infections / physiopathology
  • Central Nervous System Bacterial Infections / prevention & control
  • Deep Brain Stimulation / adverse effects*
  • Deep Brain Stimulation / methods
  • Electrodes, Implanted / adverse effects*
  • Equipment Contamination / prevention & control*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prosthesis-Related Infections / epidemiology*
  • Prosthesis-Related Infections / physiopathology
  • Prosthesis-Related Infections / prevention & control
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome