A CLOSER LOOK AT DBS SURGERY DBS THERAPY FOR DYSTONIA

WHAT HAPPENS DURING DBS SURGERY?

So that you can receive DBS Therapy, a device similar to a pacemaker is placed under the skin in your chest. Very thin wires connect the device to your brain to enable the signals to reach the source of your symptoms. Here's what to expect during and after the procedure that makes therapy possible.

Having the Procedure

The duration and steps of the implant procedure can vary, and the procedure typically lasts several hours. The hospital stay is usually a few days for the preoperative tests, planning, implant procedure, and initial recovery before home care.

People who have had the procedure usually describe it as demanding and exhausting rather than painful. Afterwards, you may have some discomfort and soreness that can be managed with pain medication.

Implanting the Leads

During the surgery to implant your DBS system for dystonia,^* your doctor will use the following techniques to determine the area in your brain where the leads will be placed:

• You will receive local or general anesthesia before this procedure.
• Your surgeon may test stimulate areas of your brain to determine the best placement for the lead.
• When the best target in the brain is located, the lead is then passed into the brain.

Implanting the Neurostimulator

The neurostimulator may be implanted the same day or later. You will be sedated and asleep for this part of the procedure. The surgeon begins by checking to see that the leads are properly positioned.

The neurostimulator is placed under the skin of your chest just below the collar bone. The surgeon will also connect the lead to the neurostimulator with extensions that are placed under the skin, leading up from the chest to your neck and head.

THE HEALING PROCESS

People usually go home a few days after the surgery. Healing can take several weeks. Discomfort or pain at the incision sites can be managed with medication. When you are sent home to heal, typically your device will not be turned on until your first programming session.

For several weeks you will avoid strenuous activity, arm movements over your shoulder, and excessive stretching of your neck. You may gradually want to try activities that were difficult before your surgery. Talk about this with your doctor first, and be sure to follow all of your doctor's instructions.

Programming Sessions

After you have healed from the procedure, your doctor will program the device to best control your individual symptoms while minimizing side effects. You will return for follow-up sessions to further adjust the settings. Periodic adjustments are a routine part of DBS Therapy.

The full effect of the therapy may not be immediate. You will see the best results after the system has been fine-tuned for your specific symptom control needs. It may take several months to reach maximum effect.

Depending on the system and your therapy needs, you may have a controller that will allow you to turn the system on and off, adjust the stimulation, and check the battery.

WHAT ARE THE RISKS OF THE DBS SURGERY?

Placing the DBS system requires brain surgery, which could have serious and even fatal complications including coma, bleeding inside the brain, stroke, seizures, and infection. Once implanted, the system may become infected, parts may wear through the skin, and the lead and/or extension connector may move. Medtronic DBS Therapy could stop suddenly because of mechanical or electrical problems. Any of these situations may require additional surgery or cause symptoms to return or worsen, which may be life-threatening. Medtronic DBS Therapy may cause new or worsening neurological or psychiatric symptoms.

In patients receiving Medtronic DBS Therapy, depression, suicidal thoughts, and suicide have been reported.

This therapy is not for everyone. This therapy should not be used for patients who will be exposed to diathermy (deep heat treatment) or transcranial magnetic stimulation. Magnetic Resonance Imaging (MRI) should only be performed as described in the product labeling. The DBS system may interact with other medical devices and electromagnetic interference.

Talk to your doctor about the risks that may be applicable to your specific situation.