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Revision Surgery of Deep Brain Stimulation Leads.

Steven M Falowski1, Roy A E Bakay2

  • 1Department of Neurosurgery, St. Lukes University Health Network, Bethlehem, PA, USA.

Neuromodulation : Journal of the International Neuromodulation Society
|February 23, 2016
PubMed
Summary

Deep brain stimulation (DBS) lead revisions are increasingly necessary due to loss of efficacy or adverse effects. Surgical techniques are crucial for successful lead revision in movement disorder patients.

Keywords:
ComplicationParkinson's diseasedeep brain stimulationfunctional neurosurgerymicroelectrode recordingstimulationsubthalamic nucleustargetingtremor

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Area of Science:

  • Neurosurgery
  • Neurology
  • Biomedical Engineering

Background:

  • Deep brain stimulation (DBS) is a key therapy for movement disorders.
  • Increasing use of DBS leads to a rise in lead revision procedures.

Purpose of the Study:

  • To analyze the reasons and surgical techniques for DBS lead revisions.
  • To identify factors influencing the need for lead revision over time.

Main Methods:

  • Retrospective analysis of patients undergoing DBS lead revision at a single institution.
  • Review of 497 DBS lead placements, identifying 25 requiring revision.
  • Analysis included diagnosis, revision reasons, lead relocation, and surgical techniques.

Main Results:

  • Loss of efficacy and adverse effects were primary reasons for DBS lead revision.
  • Lead malfunction was an infrequent cause for revision.
  • Specific surgical techniques were developed for lead replacement, maintaining brain position.

Conclusions:

  • Surgical technique and patient-specific factors are vital for successful DBS lead revision.
  • Lead revisions are essential to restore therapeutic effects when efficacy wanes or side effects emerge.