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妥瑞氏症(TS)在深部脑刺激(DBS)的植入硬件中发生炎症并发症的比率更高。

Tourette syndrome (TS) bears a higher rate of inflammatory complications at the implanted hardware in deep brain stimulation (DBS).

机构信息

Division of Functional Neurosurgery and Tourette Center, IRCCS Galeazzi Institute, via R. Galeazzi 4, 20161, Milan, Italy.

出版信息

Acta Neurochir (Wien). 2011 Mar;153(3):629-32. doi: 10.1007/s00701-010-0851-y. Epub 2010 Nov 5.

Abstract

BACKGROUND

Deep brain stimulation (DBS) is a commonly performed surgical technique for the treatment of movement disorders, and recent surgical trials concerning the treatment of a wider range of disorders have recently been published. Despite DBS being non-ablative and minimally invasive, numerous complications and side effects have been recorded. In particular, concerning the growing interest in novel indications for DBS, an enthusiastic approach has put neurosurgeons at risk of underestimating some of the complications that might be associated with specific characters of the treated disease.

OBJECTIVE

Our objective was to evaluate hardware failures and rates of infective complications in correlation to the different indications to DBS, in order to ascertain whether DBS in Tourette syndrome (TS) is characterized by specific risks and pitfalls.

METHODS

We retrospectively reviewed our experience of 531 procedures on 272 patients treated for various movement disorders, among which 39 patients were treated for conservative treatmentrefractory TS.

RESULTS

A statistically significant association of infective complications was found with the TS subgroup.

CONCLUSIONS

It is our belief that specific behavioral characters of the TS patients may be put into association with this specific complication and need to be considered carefully when indicating DBS as treatment of choice for these patients.

摘要

背景

深部脑刺激(DBS)是一种常用于治疗运动障碍的手术技术,最近发表了一些关于治疗更广泛疾病的新手术试验。尽管 DBS 是非消融性和微创性的,但已经记录了许多并发症和副作用。特别是,随着对 DBS 新适应症的兴趣日益浓厚,积极的治疗方法使神经外科医生有低估与治疗疾病特定特征相关的某些并发症的风险。

目的

我们的目的是评估硬件故障和感染性并发症的发生率与 DBS 的不同适应症之间的相关性,以确定 DBS 在妥瑞氏综合征(TS)中的治疗是否具有特定的风险和陷阱。

方法

我们回顾性地分析了我们对 272 名接受各种运动障碍治疗的患者的 531 例手术的经验,其中 39 名患者接受了保守治疗难治性 TS 的治疗。

结果

感染性并发症与 TS 亚组存在显著的统计学关联。

结论

我们认为,TS 患者的特定行为特征可能与这种特定的并发症有关,在将 DBS 作为这些患者的首选治疗方法进行指示时,需要仔细考虑。

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