Frameless Stereotaxis for Subthalamic Nucleus Deep Brain Stimulation: An Innovative Method for the Direct Visualization of Electrode Implantation by Intraoperative X-ray Control
Autor: | Paolo Mazzone, Eugenio Scarnati, Fabio Viselli, Alessandro Stefani |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Deep brain stimulation Computer science medicine.medical_treatment Surgical planning Visual control Article 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine subthalamic nucleus medicine.diagnostic_test General Neuroscience Stereotaxis Magnetic resonance imaging deep brain stimulation frameless neurosurgery intraoperative X-ray control Nexframe Visualization Subthalamic nucleus Neurosurgery 030217 neurology & neurosurgery Biomedical engineering |
Zdroj: | Brain Sciences; Volume 8; Issue 5; Pages: 90 Brain Sciences |
ISSN: | 2076-3425 |
DOI: | 10.3390/brainsci8050090 |
Popis: | The recent introduction of frameless devices has enabled stereotactic neurosurgery to reach a level of accuracy that is comparable to traditional frame-based methodologies. Among frameless devices, the Nexframe appears to be very useful in implanting electrodes into the subthalamic nucleus or other structures for deep brain stimulation in Parkinson’s disease. However, frameless devices, including the Nexframe, limit the possibility of intraoperative visual control of the placement of electrodes in the brain. Utilizing intraoperative O-arm Computed tomography (CT) scan or high-field Magnetic Resonance Imaging (MRI) could overcome this limitation, but their high cost restricts their use. Thus, in this paper we propose an innovation in Nexframe surgical planning that allows the intraoperative use of a C-arm X-ray apparatus to establish: (1) the progression of the electrode guide tube and the electrode in the brain; (2) the accuracy of the electrode trajectory; and (3) the correct attainment of the target. The proposed frameless technique using the Nexframe has been developed and successfully applied in our practice. It was shown to be helpful in overcoming the major issues that are usually encountered when electrodes are placed in the brain with frameless neurosurgery and reduced the risk of having to re-operate on patients to reposition the electrodes. |
Databáze: | OpenAIRE |
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