Mostofi, A; Baig, F; Bourlogiannis, F; Uberti, M; Morgante, F; Pereira, E
(2021)
Postoperative Externalization of Deep Brain Stimulation Leads Does Not Increase Infection Risk.
NEUROMODULATION, 24 (2).
pp. 265-271.
ISSN 1094-7159
https://doi.org/10.1111/ner.13331
SGUL Authors: Mostofi, Abteen Morgante, Francesca
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Abstract
Objectives Externalization of deep brain stimulation (DBS) leads is performed to allow electrophysiological recording from implanted electrodes as well as assessment of clinical response to trial stimulation before implantable pulse generator (IPG) insertion. Hypothetically, lead externalization provides a route for inoculation and subsequent infection of hardware, though this has not been established definitively in the literature. We sought to determine if lead externalization affects the risk of infection in DBS surgery. Materials and Methods We present our center's experience of lead externalization and surgical site infection (SSI) in DBS surgery for movement disorders. Patients were divided into two cohorts: one in which leads were not externalized and IPGs were implanted at the time of electrode insertion, and one in which leads were externalized for six days while patients underwent electrophysiological recording from DBS electrodes for research. We compare baseline characteristics of these two cohorts and their SSI rates. Results Infective complications were experienced by 3/82 (3.7%) patients overall with one (1.2%) requiring complete hardware removal. These occurred in 1/36 (2.7%) in the externalized cohort and 2/46 (4.3%) in the nonexternalized cohort. The incidence of infection between the two cohorts was not significantly different (p = 1, two‐tailed Fisher's exact test). This lack of significant difference persisted when baseline variation between the cohorts in age, hardware manufacturer, and indication for DBS were corrected by excluding patients implanted for dystonia, none of whom underwent externalization. We present and discuss in detail each of the three cases of infection. Conclusions Our data suggest that externalization of leads does not increase the risk of infective complications in DBS surgery. Lead externalization is a safe procedure which can provide a substrate for unique neurophysiological studies to advance knowledge and therapy of disorders treated with DBS.
Item Type: | Article | ||||||||
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Additional Information: | This is the peer reviewed version of the following article: Mostofi, A., Baig, F., Bourlogiannis, F., Uberti, M., Morgante, F. and Pereira, E.A.C. (2021), Postoperative Externalization of Deep Brain Stimulation Leads Does Not Increase Infection Risk. Neuromodulation: Technology at the Neural Interface, 24: 265-271, which has been published in final form at https://doi.org/10.1111/ner.13331. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. | ||||||||
Keywords: | 1103 Clinical Sciences, 1109 Neurosciences, 1702 Cognitive Sciences, Neurology & Neurosurgery | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||||
Journal or Publication Title: | NEUROMODULATION | ||||||||
ISSN: | 1094-7159 | ||||||||
Dates: |
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Publisher License: | Publisher's own licence | ||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/112693 | ||||||||
Publisher's version: | https://doi.org/10.1111/ner.13331 |
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