Department of Neurosurgery, Evangelismos General Hospital, Athens, Greece.
Acta Neurochir (Wien). 2010 Dec;152(12):2053-62. doi: 10.1007/s00701-010-0749-8. Epub 2010 Jul 25.
Deep brain stimulation (DBS) has been established as a safe and efficient method for the treatment of various movement disorders. As the emerging applications continue to expand and more centers become eligible for the procedure, complication rates and complication avoidance become increasingly important. Our aim was to report the DBS-related complication in our department over the last 7 years, compare our rates with those reported in the literature, and highlight those practices that will aid complications avoidance.
Since 2003, 106 patients underwent DBS for various pathologies in our department. There were 38 (36%) females and 68 (64%) males with a mean age of 57 years. Preoperative diagnoses included Parkinson's disease (n = 88), dystonia (n = 12), tremor (n = 3), epilepsy (n = 1), obsessive-compulsive disorder (n = 1), and central pain syndrome (n = 1). Surgical and hardware-related complications, their treatment, and outcome were recorded and compared with those reported in the literature.
There were 12 procedure-related complications (11.3% of patients, 5.7% of the procedures). These included death (n = 1), aborted procedure (n = 1), postoperative respiratory distress (n = 3), intracranial hemorrhage (n = 2), epilepsy (n = 1), postoperative confusion or agitation (n = 3), and malignant neuroleptic syndrome (n = 1). Hardware-related complications presented in 4.3% of the procedures and included infection (five patients, 4.7%), electrode breakage (0.94%), lead migration or misplacement (0.94%), and stricture formation (two patients, 1.9%).
Complication rates after DBS surgery remain low, proving that DBS is not only effective but also safe. Certain strategies do exist in order to minimize complications.
脑深部电刺激（DBS）已被确立为治疗各种运动障碍的安全有效的方法。随着新兴应用的不断扩展，越来越多的中心有资格进行该手术，并发症发生率和并发症预防变得越来越重要。我们的目的是报告过去 7 年来我们科室的 DBS 相关并发症，将我们的发生率与文献报告的发生率进行比较，并强调那些有助于预防并发症的做法。
自 2003 年以来，我们科室有 106 名患者因各种疾病接受了 DBS。其中 38 名（36%）为女性，68 名（64%）为男性，平均年龄为 57 岁。术前诊断包括帕金森病（n=88）、肌张力障碍（n=12）、震颤（n=3）、癫痫（n=1）、强迫症（n=1）和中枢性疼痛综合征（n=1）。记录手术和硬件相关并发症、治疗方法和结果，并与文献报告的结果进行比较。
有 12 例与手术相关的并发症（占患者的 11.3%，占手术的 5.7%）。其中包括死亡（n=1）、手术中止（n=1）、术后呼吸窘迫（n=3）、颅内出血（n=2）、癫痫（n=1）、术后意识模糊或激越（n=3）和恶性神经阻滞剂综合征（n=1）。硬件相关并发症在 4.3%的手术中出现，包括感染（5 例，4.7%）、电极断裂（0.94%）、导联移位或错位（0.94%）和狭窄形成（2 例，1.9%）。
DBS 手术后的并发症发生率仍然较低，证明 DBS 不仅有效而且安全。确实存在一些策略可以将并发症的风险降到最低。
