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Related Experiment Video

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Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
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Infections in Deep Brain Stimulator Surgery.

Jacob E Bernstein1, Samir Kashyap1, Kevin Ray1

  • 1Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA.

Cureus
|October 22, 2019
PubMed
Summary

Deep brain stimulation (DBS) infections are less common than previously reported, with most occurring early after surgery. Vancomycin powder did not reduce infection risk and may increase it after electrode implantation.

Keywords:
dbsdeep brain stimulator infection

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Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Biomedical Engineering

Background:

  • Deep brain stimulation (DBS) is a vital treatment for movement disorders like Parkinson's disease.
  • Infection rates following DBS implantation vary significantly, posing a challenge to patient management.
  • Current infection management often involves antibiotics, debridement, and hardware removal.

Purpose of the Study:

  • To evaluate infection rates and outcomes after DBS and implantable pulse generator (IPG) placement.
  • To identify risk factors and effective management strategies for DBS-related infections.
  • To compare infection rates between initial implantation and IPG replacement surgeries.

Main Methods:

  • Retrospective review of 203 patients undergoing DBS procedures.
  • Analysis of infection occurrence, timing (early vs. late), and location.
  • Comparison of infection rates based on surgical procedures (electrode insertion vs. IPG replacement) and antibiotic use (intra-operative vancomycin).

Main Results:

  • Overall infection rate was 3% for electrode implantation and 0.8% for IPG replacement.
  • Most infections were early (<90 days) and occurred at the chest or connector sites.
  • Intra-operative vancomycin powder use was associated with an increased risk of infection after electrode implantation (RR 5.5080, p=0.02063).
  • No intracranial abscesses were observed.
  • Patients treated with antibiotics and retained hardware showed no recurrent infections.

Conclusions:

  • DBS-related infection rates in this study are lower than historical data.
  • Intra-operative vancomycin is not recommended for reducing infection risk and may increase it.
  • Conservative management with antibiotics and retained hardware is effective for select patients.
  • Early detection and management are crucial for favorable outcomes in DBS infections.