Document Detail


Analysis of stereotactic accuracy of the cosman-robert-wells frame and nexframe frameless systems in deep brain stimulation surgery.
MedLine Citation:
PMID:  20588080     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The primary goal of stereotactic systems in deep brain stimulation (DBS) surgery is accurate delivery of a DBS lead to a target identified on imaging. Thus, it is critical to understand the accuracy of the stereotactic systems and the factors which may be associated with a decrease in accuracy.
METHODS: Ninety patients underwent microelectrode recording-guided placement of 139 DBS leads by a single surgeon using the Cosman-Roberts-Wells (CRW) frame (n = 70) or a frameless skull-mounted trajectory guide (Nexframe; n = 69). The final DBS location was identified on a postoperative CT fused to the preoperative CT and MRI scans. The difference between this final location and the expected location was calculated.
RESULTS: The vector error was 2.65 mm (standard error, 0.22) for the frame and 2.78 mm (standard error, 0.25) for the frameless methods (p = 0.69). There was a gradual decline in error for both systems over time, as the vector error of the last 20 implants was 1.99 for the CRW frame and 2.04 for the Nexframe (p = 0.86).
CONCLUSIONS: This study shows that the CRW frame and Nexframe frameless systems have equivalent accuracy. Furthermore, the accuracy of both techniques improved over time, from 3 mm initially to 2 mm with current techniques.
Authors:
Craig Kelman; V Ramakrishnan; Alex Davies; Kathryn Holloway
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-24
Journal Detail:
Title:  Stereotactic and functional neurosurgery     Volume:  88     ISSN:  1423-0372     ISO Abbreviation:  Stereotact Funct Neurosurg     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-14     Completed Date:  2010-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8902881     Medline TA:  Stereotact Funct Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  288-95     Citation Subset:  IM    
Copyright Information:
2010 S. Karger AG, Basel.
Affiliation:
Department of Neurosurgery, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, VA 980631, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Chi-Square Distribution
Deep Brain Stimulation / instrumentation
Globus Pallidus / surgery*
Humans
Implantable Neurostimulators
Male
Parkinson Disease / surgery*
Stereotaxic Techniques / instrumentation*
Subthalamic Nucleus / surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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