Rescuing Infected Deep Brain Stimulation Therapies in Severely Affected Patients

Area of Science:

• Neurosurgery
• Infectious Disease Management
• Medical Device Technology

Background:

• Infections are a known complication of deep brain stimulation (DBS) hardware.
• Visible hardware infections often necessitate complete system removal and post-removal care.
• A novel surgical technique was developed to address this complication and avoid extensive patient care.

Purpose of the Study:

• To describe and evaluate a novel surgical technique for managing deep brain stimulation hardware infections.
• To assess the safety and efficacy of this technique as an alternative to complete system explantation.

Main Methods:

• A case series of six patients undergoing a novel DBS hardware infection management technique.
• The technique involves repositioning electrodes contralaterally, introducing new extensions and a contralateral generator, followed by removal of the infected system.
• Patients were monitored for infection recurrence and hardware functionality.

Main Results:

• The average duration of DBS system implantation before the revision surgery was 272 days.
• Only one of the six systems required removal after 18 months due to recurrent infection; the others remained functional.
• Laboratory evidence of infection or identified pathogens was present in only half of the patients.

Conclusions:

• The described surgical technique is a safe and well-tolerated alternative to complete deep brain stimulation system removal.
• This novel approach effectively prevents the need for post-removal care in patients with DBS hardware infections.
• The technique demonstrates promising results in managing hardware infections while maintaining DBS therapy.