Surgical and hardware complications of subthalamic stimulation

OBJECTIVE: To assess the surgical and hardware complications in a series of 81 consecutive patients undergoing subthalamic (STN) deep brain stimulation (DBS) for Parkinson disease (PD). METHODS: The authors prospectively documented surgical and hardware complications occurring at the time of surgery and at subsequent neurologic and surgical evaluations for an average of 17 months, ranging from 1 to 54 months. RESULTS: No patient had a serious surgical complication resulting in death or permanent neurologic deficit. One patient had an intracranial hemorrhage but with no permanent deficit. In follow-up, 2.5% had infections requiring system removal, 3.7% had infections requiring implantable pulse generator (IPG) removal, 12.5% had misplaced leads, and 26.2% had hardware complications including lead migration, lead fracture, extension erosion, extension fracture, and IPG malfunction. CONCLUSION: Serious complications leading to permanent neurologic deficit are rare after STN DBS for advanced PD. However, long-term follow-up demonstrated that hardware complications are relatively common, having occurred in approximately 26% of these patients.