Evaluation of Patient Perspectives Toward Awake, Frame-Based Deep-Brain Stimulation Surgery.

Evaluation of Patient Perspectives Toward Awake, Frame-Based Deep-Brain Stimulation Surgery.

World Neurosurg. 2017 Dec 27;:

Authors: Ben-Haim S, Falowski S

Abstract
BACKGROUND: Deep brain stimulation (DBS) is an effective therapeutic modality, however only a percentage of eligible patients undergo the procedure.
OBJECTIVES: To study patients perspectives towards Deep-Brain Stimulation (DBS) surgery.
METHODS: A survey was sent to 95 consecutive adult patients who underwent DBS surgery for Parkinson's disease, essential tremor, or dystonia with a 73% response rate(69 patients). Post-hoc analyses were performed evaluating factors that led to favorable outcomes. The average time between surgical procedure to survey completion was 16 months.
RESULTS: Awake-surgery, use of a rigid head-frame, and having hair clipped were seldom reported as major deterrents to surgery. Patients retrospectively report an average comfort level of 8.3±1.8 during surgery. The average comfort level with head-frame placement was reported as 5.2±3.15, and those patients reporting discomfort with the frame nonetheless reported overall comfort with the procedure (8.7±1.8). An analysis of satisfaction revealed that 90% of patients would recommend the procedure to a family member or friend, and that 78 % of patients would undergo the procedure again. A post-hoc analysis of patients that were not satisfied with the procedure revealed that this subset reported significantly less overall comfort (6.9+/-1.7, p=0.0003), and were less likely to report that the goals and expectations of surgery were clearly discussed prior to surgery (p=0.0004) CONCLUSIONS: Frame placement, awake surgery, and head shaving did not appear to play a significant role in most patients' decision-making process to undergo DBS, as analyzed in this retrospective cohort. The majority of patients are satisfied with the procedure and report being comfortable. Managing goals and expectations pre-operatively plays a significant role in ultimate overall satisfaction.

PMID: 29288853 [PubMed - as supplied by publisher]

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