Analysis of Device-Related Infection after Deep Brain Stimulation Surgery

Abstract

Device-related infection frequently becomes a serious problem after deep brain stimulation(DBS)surgery and DBS device removal is usually the only effective treatment option. In this study, we examined risk factors for infection related to DBS devices at our institution. We retrospectively investigated 80 DBS surgeries performed between March 2009 and September 2017 at our institution. We examined the relationship between DBS device-related infection and the following items:duration of electrode placement surgery, total number of tracks of microelectrode recordings(MER), period between surgeries, highest body temperature until implantable pulse generator(IPG)implantation, and patient background characteristics. Four(5.0%)patients developed device-related infection after DBS surgery. Three of them required device removal, whereas one improved following antibiotic treatment alone. We did not identify any specific trend or risk factor for infection. We perform DBS surgery in two stages. Patients were implanted with an IPG 2-3 days after electrode placement until August 2016, and at 6-8 days starting in September 2016. All cases of infection developed before September 2016, and no cases of infection have occurred since September 2016. We believe that lengthy surgical electrode placement affects the general status of patients and performing surgery before stabilization might confer a risk of infection. Device-related infection after DBS surgery does not seem to be associated with any risk factors. However, a shorter period between two-staged surgeries might affect infection rates.