Intraoperative 3D imaging control during subthalamic Deep Brain Stimulation procedures using O-arm® technology: Experience in 15 patients

F. Caire, D. Guehl, P. Burbaud, A. Benazzouz, E. Cuny
Neurochirurgie. 2014-12-01; 60(6): 276-282
DOI: 10.1016/j.neuchi.2014.05.005

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Caire F(1), Guehl D(2), Burbaud P(2), Benazzouz A(3), Cuny E(4).

Author information:
(1)Service de neurochirurgie, CHU de Limoges, 87000 Limoges, France; Institut
des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France. Electronic
address: .
(2)Unité d’électrophysiologie et exploration fonctionnelle du système nerveux,
CHU de Bordeaux, 33000 Bordeaux, France; Institut des Maladies
Neurodégénératives, UMR 5293, 33000 Bordeaux, France.
(3)Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France.
(4)Service de neurochirurgie A, CHU de Bordeaux, 33000 Bordeaux, France;
Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France.

OBJECTIVE: O-arm(®) now gives us the opportunity not only to perform 2D but also
3D scans during deep brain stimulation (DBS) procedures. We present our
experience with the intraoperative use of this device. Our objective was to
measure the geometrical accuracy of electrode placement during surgical
procedures driven under O-arm(®) control.
METHODS: Fifteen patients underwent STN-DBS. For the first 4 patients, 3D scans
were performed at the end of the procedure. We calculated the accuracy of
electrode positioning, i.e. the distance between final electrode positioning and
the planned trajectory. For the next 11 patients, who underwent both
intraoperative and final 3D scan, we also calculated the accuracy of the
microelectrode positioning.
RESULTS: Average stimulation-induced improvement of UPDRS-III score was
52.5±15%. For the first 4 patients, the mean electrode positioning accuracy was
1.46±0.56mm. For the 11 patients who underwent intraoperative 3D scan, the mean
microelectrodes positioning accuracy was 1.59±1.1mm. Aberrant positioning was
detected in two cases, and was analyzed by fusing 3D scan with preoperative MR
images. The definite electrodes positioning accuracy was 1.05±0.54mm.
CONCLUSION: Intraoperative 3D scan is feasible, and can help us detect and
correct early aberrant trajectories.

Copyright © 2014 Elsevier Masson SAS. All rights reserved.

 

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