Clinical evaluation of multimodality registration in frameless stereotaxy

Villalobos, Hunaldo; Germano, Isabelle M.

doi:10.1002/(sici)1097-0150(1999)4:1<45::aid-igs5>3.0.co;2-p

Cited by 21 publications

(18 citation statements)

References 23 publications

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“…Selfadhesive skin markers (SM) are the most commonly used markers in clinical practice and have been reported to err by 1.5 mm to 4 mm by various authors [2,4,7,12,13,16]. This corresponds to our own experience, with a calculated mean error of 2-4 mm [9,10,11].…”

Section: Discussionmentioning

confidence: 53%

Anatomical landmarks for image registration in frameless stereotactic neuronavigation

et al. 2002

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Section: Discussionmentioning

confidence: 53%

Anatomical landmarks for image registration in frameless stereotactic neuronavigation

et al. 2002

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“…3,15,17 Conversely, these frameless interventions depend on the surgeon's hand-eye coordination, thereby potentially introducing inaccuracies. 5,16 Accordingly, although both frame-based and frameless approaches provide very high localization accuracy in the laboratory setting, their accuracy decreases significantly when applied in a clinical setting. 12 Consequently, medical robots have been introduced to counter some of these limitations.…”

Section: Discussionmentioning

confidence: 99%

Blurring the boundaries between frame-based and frameless stereotaxy: feasibility study for brain biopsies performed with the use of a head-mounted robot

Grimm

Naros

Gutenberg

et al. 2015

JNS

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OBJECT Frame-based stereotactic interventions are considered the gold standard for brain biopsies, but they have limitations with regard to flexibility and patient comfort because of the bulky head ring attached to the patient. Frameless image guidance systems that use scalp fiducial markers offer more flexibility and patient comfort but provide less stability and accuracy during drilling and biopsy needle positioning. Head-mounted robot-guided biopsies could provide the advantages of these 2 techniques without the downsides. The goal of this study was to evaluate the feasibility and safety of a robotic guidance device, affixed to the patient’s skull through a small mounting platform, for use in brain biopsy procedures. METHODS This was a retrospective study of 37 consecutive patients who presented with supratentorial lesions and underwent brain biopsy procedures in which a surgical guidance robot was used to determine clinical outcomes and technical procedural operability. RESULTS The portable head-mounted device was well tolerated by the patients and enabled stable drilling and needle positioning during surgery. Flexible adjustments of predefined paths and selection of new trajectories were successfully performed intraoperatively without the need for manual settings and fixations. The patients experienced no permanent deficits or infections after surgery. CONCLUSIONS The head-mounted robot-guided approach presented here combines the stability of a bone-mounted set-up with the flexibility and tolerability of frameless systems. By reducing human interference (i.e., manual parameter settings, calibrations, and adjustments), this technology might be particularly useful in neurosurgical interventions that necessitate multiple trajectories.

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“…The evolution of IGS registration and the advent of iCT have taken spine IGS from a "procedurally challenged" undertaking to everyday use in the operating room. 14,15,33 …”

Section: Registrationmentioning

confidence: 99%

Introduction: Intraoperative spinal imaging and navigation

Drazin¹,

Kim

Polly

et al. 2014

FOC

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Image-guided surgery (IGS) has been evolving since the early 1990s and is now used on a daily basis in the operating theater for spine surgery at many institutions. In the last 5 years, spinal IGS has greatly benefitted from important enhancements including portable intraoperative CT (iCT) coupled with high-speed computerized stereotactic navigation systems and optical-based camera tracking technology. Historical PerspectiveCranial stereotaxy was developed by Kirschner in 1933, refined by Lars Leksell in 1949, and translated by Robert Brown and Theodore Roberts in 1979 into the Brown-Roberts-Wells stereotactic system. 21,24,28,35 Cranial stereotaxy employed frames that were attached to the skull for numerous surgical intracranial procedures including intraaxial and skull base tumor resection, vascular malformation resection, resection for epilepsy, and ablation and stimulation procedures for Parkinson's disease and other functional disorders. 3,4,11,12 Today, frame-based technology is used only for some cranial procedures in which the highest possible accuracy is needed. Frame-based cranial stereotaxy led to the development of frameless cranial stereotaxy. Frameless cranial stereotaxy, in turn, led to the development of spinal frameless stereotaxy, now referred to simply as IGS for both cranial and spinal procedures. 18,40 Frame-Based and Frameless Spinal Stereotaxy ProceduresFor a period of time, frame-based spinal technology was used for the limited applications of stereotactic radiosurgery to treat spinal neoplasms. 25,32 Since the advent of frameless stereotactic radiosurgery procedures, framebased procedures are rarely, if ever, used. The "frameless stereotaxy" that we currently use is now referred to as spinal IGS. This technology utilizes 3D imaging reconstruction produced by iCT scanning, digital optical imaging systems, and high-speed computer processing. Instead of the attached frame previously used, this technology uses only a tracking device attached to the spine to create the 3D computerized tracking environment.As clinical applications for frameless spinal stereotaxy evolved, they were reported in the literature. In 1991, Nelson and Duwelius reported their novel application of iCT to facilitate sacral fixation.26 In 1993, Brodwater et al. described utilization of the microscope to evaluate lumbar spinal anatomy, creating an interest in the use of IGS for hardware placement. 6 In 1995, Kalfas and colleagues published their experience with IGS-based placement of pedicle screws in the lumbar spine, in what appears to be the initial application of spinal IGS for hardware placement. 17 In 1996, Foley and Smith published a paper presenting a broader clinical application of IGS technology to spine surgery procedures.9 Following these initial publications, IGS for spinal procedures in various regions of the spinal column were reported by surgeons from across the country. 2,5,15,20,38

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Clinical evaluation of multimodality registration in frameless stereotaxy

Cited by 21 publications

References 23 publications

Anatomical landmarks for image registration in frameless stereotactic neuronavigation

Anatomical landmarks for image registration in frameless stereotactic neuronavigation

Blurring the boundaries between frame-based and frameless stereotaxy: feasibility study for brain biopsies performed with the use of a head-mounted robot

Introduction: Intraoperative spinal imaging and navigation

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