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Postoperative Externalization of Deep Brain Stimulation Leads Does Not Increase Infection Risk
Abteen Mostofi1,2, Fahd Baig1,3, Fotios Bourlogiannis2
1Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.
Neuromodulation : Journal of the International Neuromodulation Society
|December 10, 2020
Summary
Externalizing deep brain stimulation (DBS) leads for research does not increase surgical site infection risk. This safe procedure allows valuable neurophysiological studies for movement disorder treatments.
Area of Science:
- Neurosurgery
- Medical Devices
- Infectious Disease
Background:
- Deep brain stimulation (DBS) lead externalization is used for electrophysiological recording and trial stimulation before implantable pulse generator (IPG) insertion.
- A potential risk of lead externalization is hardware infection, though this remains unproven in the literature.
Observation:
- This study compared surgical site infection (SSI) rates in DBS patients with and without lead externalization.
- Patients undergoing lead externalization (n=36) had a 2.7% infection rate, compared to 4.3% in those without externalization (n=46).
Findings:
- The overall infection rate was 3.7%, with no significant difference in SSI rates between the externalized and non-externalized cohorts (p = 1).
- This finding remained consistent after adjusting for patient age, hardware manufacturer, and DBS indication.
Implications:
- Lead externalization in DBS surgery does not appear to elevate the risk of infective complications.
- This procedure is safe and facilitates crucial neurophysiological research to improve DBS therapies for movement disorders.
