Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experience
Introduction: Vagus nerve stimulation (VNS) is the most frequently used neuromodulation treatment for Drug-Resistant Epilepsy (DRE) patients. Complications of VNS surgery include surgical site infection and unilateral vocal cord paresis. Complication rates vary across studies. Research question: Wha...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
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| Series: | Brain and Spine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529423010214 |
| _version_ | 1797383603933413376 |
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| author | Jouke van Schooten Jacco Smeets Sander MJ. van Kuijk Sylvia Klinkenberg Olaf E.M.G. Schijns Jeske Nelissen Louis G.L. Wagner Rob P.W. Rouhl Marian H.J.M. Majoie Kim Rijkers |
| author_facet | Jouke van Schooten Jacco Smeets Sander MJ. van Kuijk Sylvia Klinkenberg Olaf E.M.G. Schijns Jeske Nelissen Louis G.L. Wagner Rob P.W. Rouhl Marian H.J.M. Majoie Kim Rijkers |
| author_sort | Jouke van Schooten |
| collection | DOAJ |
| description | Introduction: Vagus nerve stimulation (VNS) is the most frequently used neuromodulation treatment for Drug-Resistant Epilepsy (DRE) patients. Complications of VNS surgery include surgical site infection and unilateral vocal cord paresis. Complication rates vary across studies. Research question: What is the safety profile of VNS related surgeries? Materials and methods: Retrospective cohort study using patient files of DRE-patients who had undergone primary implantation of a VNS-system, replacement of the VNS pulse generator, replacement of the lead, replacement of both pulse generator and lead, or VNS removal surgery in the Maastricht UMC+. Multiple Imputation was used for missing data. Univariable and multivariable logistic regression analysis were performed to analyze possible risk factors, in case of a small sample size, an independent-samples t-test and Fisher's exact test or Pearson's X2-test were used. The complication rate was calculated as percentage. Results: This study included a total of 606 VNS surgical procedures, leading to 67 complications of which 3 permanent complications. Complication rate after primary implantation was 13.4%; 2,5% for pulse generator replacement; 21.4% for lead revision and 27.3% for complete VNS removal. No statistically significant results were found when analyzing the results of adults and children <18 years separately. Discussion and conclusion: Complication rates of VNS-related surgeries in our own institutional series are low and comparable to previously reported series. VNS surgery is a relatively safe procedure. The complication rate differs per type of surgery and mean surgery duration was longer for patients with complications after lead revision surgery compared to patients without complications. |
| first_indexed | 2024-03-08T21:23:27Z |
| format | Article |
| id | doaj.art-a69e06c912154fe5a9b772461b134fff |
| institution | Directory Open Access Journal |
| issn | 2772-5294 |
| language | English |
| last_indexed | 2024-03-08T21:23:27Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj.art-a69e06c912154fe5a9b772461b134fff2023-12-21T07:38:43ZengElsevierBrain and Spine2772-52942024-01-014102733Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experienceJouke van Schooten0Jacco Smeets1Sander MJ. van Kuijk2Sylvia Klinkenberg3Olaf E.M.G. Schijns4Jeske Nelissen5Louis G.L. Wagner6Rob P.W. Rouhl7Marian H.J.M. Majoie8Kim Rijkers9Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Neurosurgery, Maastricht University Medical Center, the NetherlandsFaculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Neurosurgery, Maastricht University Medical Center, the Netherlands; Corresponding author. Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands.Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, the NetherlandsSchool for Mental Health & Neuroscience, Maastricht University, the Netherlands; Department of Neurology, Maastricht University Medical Center, the Netherlands; ACE: Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht, Heeze, the NetherlandsDepartment of Neurosurgery, Maastricht University Medical Center, the Netherlands; School for Mental Health & Neuroscience, Maastricht University, the Netherlands; ACE: Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht, Heeze, the NetherlandsDepartment of Neurosurgery, Maastricht University Medical Center, the Netherlands; ACE: Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht, Heeze, the NetherlandsSchool for Mental Health & Neuroscience, Maastricht University, the Netherlands; ACE: Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht, Heeze, the NetherlandsSchool for Mental Health & Neuroscience, Maastricht University, the Netherlands; Department of Neurology, Maastricht University Medical Center, the Netherlands; ACE: Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht, Heeze, the NetherlandsSchool for Mental Health & Neuroscience, Maastricht University, the Netherlands; Department of Neurology, Maastricht University Medical Center, the Netherlands; ACE: Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht, Heeze, the NetherlandsDepartment of Neurosurgery, Maastricht University Medical Center, the Netherlands; School for Mental Health & Neuroscience, Maastricht University, the Netherlands; ACE: Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht, Heeze, the NetherlandsIntroduction: Vagus nerve stimulation (VNS) is the most frequently used neuromodulation treatment for Drug-Resistant Epilepsy (DRE) patients. Complications of VNS surgery include surgical site infection and unilateral vocal cord paresis. Complication rates vary across studies. Research question: What is the safety profile of VNS related surgeries? Materials and methods: Retrospective cohort study using patient files of DRE-patients who had undergone primary implantation of a VNS-system, replacement of the VNS pulse generator, replacement of the lead, replacement of both pulse generator and lead, or VNS removal surgery in the Maastricht UMC+. Multiple Imputation was used for missing data. Univariable and multivariable logistic regression analysis were performed to analyze possible risk factors, in case of a small sample size, an independent-samples t-test and Fisher's exact test or Pearson's X2-test were used. The complication rate was calculated as percentage. Results: This study included a total of 606 VNS surgical procedures, leading to 67 complications of which 3 permanent complications. Complication rate after primary implantation was 13.4%; 2,5% for pulse generator replacement; 21.4% for lead revision and 27.3% for complete VNS removal. No statistically significant results were found when analyzing the results of adults and children <18 years separately. Discussion and conclusion: Complication rates of VNS-related surgeries in our own institutional series are low and comparable to previously reported series. VNS surgery is a relatively safe procedure. The complication rate differs per type of surgery and mean surgery duration was longer for patients with complications after lead revision surgery compared to patients without complications.http://www.sciencedirect.com/science/article/pii/S2772529423010214Vagus nerve stimulationEpilepsySurgical complications |
| spellingShingle | Jouke van Schooten Jacco Smeets Sander MJ. van Kuijk Sylvia Klinkenberg Olaf E.M.G. Schijns Jeske Nelissen Louis G.L. Wagner Rob P.W. Rouhl Marian H.J.M. Majoie Kim Rijkers Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experience Brain and Spine Vagus nerve stimulation Epilepsy Surgical complications |
| title | Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experience |
| title_full | Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experience |
| title_fullStr | Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experience |
| title_full_unstemmed | Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experience |
| title_short | Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experience |
| title_sort | surgical complications of vagus nerve stimulation surgery a 14 years single center experience |
| topic | Vagus nerve stimulation Epilepsy Surgical complications |
| url | http://www.sciencedirect.com/science/article/pii/S2772529423010214 |
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