[Many potential patients for surgery are a concern to Know about Deep Brain Stimulation surgery cost In India? The estimated cost of Deep Brain Stimulation Surgery In India usually starts $28000 however, it may go up to as much as $35000. it depends on the hospital charges and the fee charged by the surgeon. This price usually does not cover the post-operational therapy and medicine. Additional costs also involve the diagnostics before the surgery and pre-operational consultations.]
Deep Brain Stimulation Surgery is a surgery that is done to implant a device for sending electrical signals direct to brain areas that are mainly responsible for the movement of the entire body. In this surgery, electrodes are used to be placed inside the brain, which is connected to a stimulator.
DBS Surgery doesn’t damage the brain tissue; it blocks abnormal signals that cause impaired motor control. Most candidates for deep brain stimulations are patients whose symptoms cannot be controlled by medication.
DBS is a surgical procedure that implants electrodes into specific areas of your brain. A pacemaker-like device is then placed under the skin of the chest, which emits electrical impulses that regulate or block electrical signals within the targeted area.
DBS doesn’t damage the brain tissue; it blocks abnormal signals that cause impaired motor control. Most candidates for deep brain stimulations are patients whose symptoms cannot be controlled by medication.
DBS is suggested for reducing the symptoms like stiffness, walking movement problems and tremor for several treatments. Once it is done, patients get back to a healthy life once again.
Deep brain stimulation involves creating small holes in the skull to implant the electrodes, and surgery to implant the device that contains the batteries under the skin in the chest. Complications of surgery may include:
Deep brain stimulation is hence a cost vs. benefits problem. For many patients with treatment-resistant forms of Parkinson’s disease and other movement disorders, DBS can help them return to a normal life and regain quality of life.
Deep brain stimulation is not a cure, it is a way to manage unmanageable symptoms that interfere with normal functions.
An ideal candidate for DBS surgery is under 70 years old and is in good health. Patients who fluctuate between “on” and “off” medication states are usually good surgical candidates, as are those who have troublesome dyskinesias.
You will typically undergo tests (e.g., blood test, electrocardiogram, chest X-ray) several days before surgery. An MRI scan of your brain will be performed. In the doctors office you will sign consent forms and complete paperwork to inform the surgeon about your medical history, including allergies, medicines, anesthesia reactions, and previous surgeries.
Stop taking all non-steroidal anti-inflammatory medicines (Naprosyn, Advil, Motrin, Nuprin, Aleve, etc.) 1 week before surgery. Stop smoking, chewing tobacco, and drinking alcohol 1 week before and 2 weeks after surgery because these activities can cause bleeding problems. You may also need to have clearance from your primary care physician or cardiologist if you have a history of other medical or heart conditions. No food or drink, including your Parkinson’s medication, is permitted after midnight the night before surgery.
Try to get a good night’s sleep. The DBS surgery involves multiple steps and lasts most of the day, during which you will be awake and off medication.
Arrive at the hospital 2 hours before your scheduled surgery time to complete the necessary paperwork and pre-procedure work-ups. An anesthesiologist will talk with you and explain the effects of anesthesia and its risks. An intravenous (IV) line will be placed in your arm.
DBS surgery can be performed while you are awake (with local anaesthesia and mild sedation) or asleep (local anaesthesia). Some people may remain awake for a part of surgery and asleep during the other part.
If the surgery is performed while the patient is awake, a local anaesthesia is used to numb the scalp and no anaesthesia is required for the brain as it does not have any pain receptors.
The doctors may ask the patient to stop taking the medicines that control Parkinson’s symptoms. During the procedure, the patient is asked to perform certain tasks to help guide the surgeon while placing electrode in the accurate part of the brain.
However, remaining awake during a brain surgery or not taking medicine can be unsettling for some people. So using a general anaesthesia is an alternative option as the patient will be unconscious during the surgery.
The hair is shaved about an inch wide along the incision line. A skin incision is made across the top of your head to expose the skull. Using a drill, two quarter-sized burr holes are made on the left and right sides of the skull (Fig 3). These holes allow the electrodes to be passed through the brain.
After surgery, you may take your regular dose of Parkinson’s medication immediately. You are kept overnight for monitoring and observation. Most patients are discharged home the next day.
During the recovery time after implanting the electrodes, you may feel better than normal. Brain swelling around the electrode tip causes a lesion effect that lasts a couple days to weeks. This temporary effect is a good predictor of your outcome once the stimulator is implanted and programmed.
About a week later, you will return to the hospital for outpatient surgery to implant the stimulator in the chest/abdomen. This surgery is performed under general anesthesia and takes about an hour. Patients go home the same day.
In the operation theatre, the surgeon will reopen a portion of incision on the scalp to access the leads. Then a small incision is made near the collarbone where the neurostimulator will be implanted under the skin. The electrode/lead is attached to the extension wire that is passed under the skin down the neck to connect to the stimulator/battery in the chest.
The stimulator might be visible as a small bulge under the skin, but it usually remains hidden under the clothes.
It is advisable to avoid movement of arm over the shoulder or an excessive stretching of the neck as the incision heals.
About 10 days after surgery, you will be scheduled for an office visit. The stimulator will be programmed and your medication dosage will be adjusted. You may be asked to stop taking your medications for up to 12 hours before the programming session. This is done to increase the effectiveness of the programming in reducing your usual symptoms. It is important that you work with the neurologist and nurse to adjust your medications and refine the programming. You will return to the office every 3 weeks for programming. It typically takes 3 to 4 programming sessions to attain maximum symptom control while minimizing side effects.
Most people don’t feel the stimulation as it reduces their symptoms. However, some people may feel a brief tingling sensation when the stimulator is first turned on.
It’s important to remember that Parkinson’s disease is progressive and symptoms get worse over time. You will return to the neurologist’s office periodically to adjust the stimulation settings.
Deep brain stimulation won’t cure your disease, but it may help lessen your symptoms. If deep brain stimulation works, your symptoms will improve significantly, but they usually don’t go away completely. In some cases, medications may still be needed for certain conditions.
Deep brain stimulation isn’t successful for everyone. There are a number of variables involved in the success of deep brain stimulation Surgery. It’s important to talk with your doctor before surgery about what type of improvement you can expect for your condition.
How long does deep brain stimulation surgery take?
The length of the operation also depends on the technique used by each center, but it often lasts between 3-6 hours from start to finish. As long as the electrodes are accurately placed, without complications, the recovery period usually lasts from between 3 to 5 days.
What is the success rate of deep brain stimulation surgery in India?
Studies report that DBS Surgery can reduce off -periods of PD symptoms by 60% (fluctuations in motor symptoms due to poor response to medicines). By reducing the need for medication, DBS Surgery rapidly decreases medication-induced dyskinesias by 60 to 80% and improves the quality of life in people with advanced PD.