Management Patterns in Deep Brain Stimulator Hardware Infection: Is Hardware Sparing Feasible?
Stereotactic and Functional Neurosurgery
|August 3, 2026
Summary
Management of deep brain stimulation (DBS) hardware infections varies. Hardware-sparing washout offers less recurrence freedom than partial or complete explantation, but may preserve stimulation.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Medical Device Management
Background:
- Deep brain stimulation (DBS) hardware infections present heterogeneously, lacking standardized management.
- Treatment options include hardware-sparing (HS) washout, partial explantation (PE), and complete explantation (CE).
Purpose of the Study:
- Evaluate outcomes of initial DBS hardware infection management strategies.
- Identify factors predicting treatment failure and escalation.
Main Methods:
- Retrospective review of 98 adult DBS patients (2002-2020) with hardware infection or erosion.
- Assessed outcomes using infection clearance and non-escalation success rates.
- Analyzed recurrence freedom with Kaplan-Meier and Cox regression.
Main Results:
- Infection clearance success: 38% (HS), 62% (PE), 59% (CE).
- Non-escalation success: 49% (HS), 78% (PE).
- PE and CE showed significantly greater recurrence freedom than HS; erosion predicted recurrence.
Conclusions:
- DBS infection outcomes depend on infection type, management, and patient goals.
- PE and CE offer superior recurrence freedom, especially for infection control.
- HS can preserve stimulation and delay escalation in select patients.
