Infrared-Based Neuronavigation and Cortical Motor Stimulation in the Management of Central-Region Tumors

Wagner, W.; Tschiltschke, W.; Niendorf, Wulf-Rüdiger; Schroeder, Henry W. S.; Gaab, M. R.

doi:10.1159/000099911

Cited by 15 publications

(3 citation statements)

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“…This reflects the lack of anatomic landmarks in these regions and underlines the significance of a technique for intraoperative orientation. In motor or speech areas, the additional functional identification of so-called eloquent structures by means of electrophysiological tests or the implementation of preoperative func-tional MR data may still enhance surgical safety [6,7,10,29,31,33].…”

Section: Discussionmentioning

confidence: 99%

Cranial Neuronavigation in Neurosurgery: Assessment of Usefulness in Relation to Type and Site of Pathology in 284 Patients

Wagner¹,

Gaab²,

Schroeder³

et al. 2000

Minim Invasive Neurosurg

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We recommend this technique in resecting tumors in eloquent areas of the cortex or white matter, in approaching deep-seated processes not visible at the cortical surface, in defining borders of tumors resembling normal brain tissue, and in guiding endoscopes where ventricles are small or vision is blurred. This recommendation applies to any neurosurgeon familiar with the technique and managing neurosurgical cases requiring precise topographical orientation where normal anatomic landmarks are missing.

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Section: Discussionmentioning

confidence: 99%

Cranial Neuronavigation in Neurosurgery: Assessment of Usefulness in Relation to Type and Site of Pathology in 284 Patients

Wagner¹,

Gaab²,

Schroeder³

et al. 2000

Minim Invasive Neurosurg

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“…It helps therefore to confine the approach to the necessary minimum, to avoid injury to normal nervous structures and to render thus surgery less invasive. Identification of functionally important areas (central region, Broca and Wernicke areas) is crucial; here, the combination of neuronavigation with intraoperative electrophysiological testing or preoperative functional MR is particularly helpful [17, 25, 26]. Five of our patients had tumors in functionally relevant areas (central, left temporal); complete resection in 4 and biopsy in 1 case resulted in no further neurologic deficits.…”

Section: Discussionmentioning

confidence: 99%

Experiences with Cranial Neuronavigation in Pediatric Neurosurgery

Wagner¹,

Gaab²,

Schroeder³

et al. 1999

Pediatr Neurosurg

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Frameless, infrared-based neuronavigation (Surgical Microscope Navigator^® and Surgical Tool Navigator^®) was applied to intracranial neurosurgery in 22 children and infants (age range 7 months to 16 years). Predominant diagnoses were tumor and hydrocephalus (including multiloculated forms); the surgical procedures were open microneurosurgery in 10 cases and neuroendoscopy in 12 patients. There were no principal technical problems even in very young infants. Surgical and clinical results were satisfying in all cases. Neuronavigation proved to be particularly helpful in targeting deep-seated processes and in guiding neuroendoscopy in cases of multiloculated hydrocephalus or small ventricles.

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“…During the surgical operations and experiments, we used three different navigation systems. Two of these, the EasyGuide (release 2, Philips Medical Systems, Eindhoven, The Netherlands)4, 28–30 and the Surgical Tool Navigator (STN) (release 3.50, Carl Zeiss, Oberkochen, Germany),23, 34 are based on localization using light‐emitting diodes for frameless stereotactic navigation. Both systems consist of five main components: a mobile planning workstation (EasyGuide: Sun SPARC 5, Sun Computer, Scottsdale, Arizona; STN: Digital alpha station 500 MHz), a position digitizer including a camera array, a pointing device, a dynamic reference frame, and a pedicle awl.…”

Section: Methodsmentioning

confidence: 99%

Incorporation of intraoperative computerized tomography in a newly developed spinal navigation technique

Haberland

Ebmeier

Grunewald

et al. 2000

Comput. Aided Surg.

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Objective: We report on the first successful incorporation of intraoperative computerized tomography in spinal navigation procedures.Materials and Methods: All operations were performed with the aid of a Tomoscan M mobile CT system (Philips Medical Systems, Eindhoven, The Netherlands). The system comprises a mobile gantry, a mobile patient examination table, and a mobile workstation. Three different navigation systems were used: the EasyGuide (Philips Medical Systems, Eindhoven, The Netherlands), the Surgical Tool Navigator (Zeiss, Oberkochen, Germany), and a prototype of an ultrasound navigation system developed by ourselves (IVS GbR, Chemnitz, Germany). All surgical operations were performed with the patient positioned on the mobile table of the CT system. Following dorsal preparation of the vertebral region, the surgeon implanted small titanium screws in the vertebrae to serve as fiducial markers. Image data acquisition and image-to-patient registration were performed after implantation of the marker screws. The pedicle screws were inserted using the navigation system, and the position of each implant was confirmed by intraoperative CT scans.Results: To date, 35 patients with various spine disorders have been operated upon using the technique described, and 161 pedicle screws have been inserted. There were no misplacements of pedicle screws. In three (1.9 %) cases we observed lateral perforation (maximum 2 mm) of the lateral pedicle wall. We achieved a registration error of 0.85 mm (RMSE) ؎ 0.42 mm (SD).Conclusions: The combination of intraoperative computerized tomography and spinal navigation allows easy navigation with a high application accuracy of 0.8 mm ؎ 0.4 mm (SD) at the target point (measured in experiments with a plastic spine model). The possibility of performing an intraoperative quality check on demand markedly improves the safety of these procedures.

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Infrared-Based Neuronavigation and Cortical Motor Stimulation in the Management of Central-Region Tumors

Cited by 15 publications

References 0 publications

Cranial Neuronavigation in Neurosurgery: Assessment of Usefulness in Relation to Type and Site of Pathology in 284 Patients

Cranial Neuronavigation in Neurosurgery: Assessment of Usefulness in Relation to Type and Site of Pathology in 284 Patients

Experiences with Cranial Neuronavigation in Pediatric Neurosurgery

Incorporation of intraoperative computerized tomography in a newly developed spinal navigation technique

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