Stereotaxic Apparatus for Operations on the Human Brain

Spiegel, E. A.; Wycis, H. T.; Marks, María Paula; Lee, A. J.

doi:10.1126/science.106.2754.349

Cited by 872 publications

(185 citation statements)

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“…Therefore, a method had to be designed to reach structures in the diencephalon and mesencephalon with maximal accuracy and minimal disturbance of the surrounding brain tissue. This led to the development of the stereotactic frame more than 60 years ago and hence to the introduction of stereotactic surgery in humans [3,4]. To date, the stereotactic frame continues to be the worldwide gold standard for stereotactic procedures, including lesioning and neuromodulation [5].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Stereotactic Accuracy in Patients Undergoing Deep Brain Stimulation Using Nexframe and the Leksell Frame

Bot

Munckhof

Bakay

et al. 2015

Stereotact Funct Neurosurg

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Objective: To determine and compare the accuracy of Nexframe and the Leksell stereotactic frame in deep brain stimulation (DBS) procedures. Background: The ‘frameless' Nexframe uses bone fiducials rather than a head-mounted frame, which offers potential benefits for both the patient and the surgical team. Accuracy of lead implantation and factors affecting this accuracy are of crucial importance but have not been extensively studied for the frameless system. Design/Methods: The location of 194 (Leksell frame, n = 116; Nexframe, n = 78) DBS leads was determined on postoperative MRI. Obtained stereotactic coordinates were compared with expected intraoperative target coordinates. Resulting absolute errors in the X (medial-lateral), Y (anterior-posterior), and Z (dorsal-ventral) coordinates (ΔX, ΔY, and ΔZ) were then used to calculate the vector error (VE). The vector error describes the total error in 3-D space and represents our main outcome measure. Results: The vector error (mean ± SD) was 2.8 ± 1.3 for Nexframe and 2.5 ± 1.2 for the Leksell frame (p = 0.43). For Nexframe, absolute X, Y, and Z errors were 1.4 ± 1.3, 1.7 ± 1.2, and 1.0 ± 0.9 mm. For the Leksell frame, the absolute X, Y, and Z errors were 1.4 ± 1.0, 1.2 ± 1.0, and 1.3 ± 0.9 mm. On the anterior-posterior plane (Y coordinate), the Leksell frame was more accurate than Nexframe (p = 0.04). In contrast, Nexframe was more accurate on the dorsal-ventral plane (Z coordinate) (p = 0.04). There was no difference in accuracy between the two methods on the medial-lateral plane (X coordinate). Conclusion: This comparison of Nexframe and the Leksell frame shows that both techniques have equivalent overall 3-D accuracy.

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Section: Introductionmentioning

confidence: 99%

Analysis of Stereotactic Accuracy in Patients Undergoing Deep Brain Stimulation Using Nexframe and the Leksell Frame

Bot

Munckhof

Bakay

et al. 2015

Stereotact Funct Neurosurg

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“…Despite Clarke's suggestion to use stereotaxis for the treatment of brain tumors, Horsley did not consider applications beyond the laboratory, and human use in subcortical stereotaxis came into practice only after Spiegel and Wycis's proposal to apply stereotaxis in the management of human brain neoplasms [2][3][4] . Meanwhile, Leksell established the basis of a novel system combining the cartesian system with other systems, which consisted of an apparatus fixed to Guiot et al 6,7 and Riechert and Mundinger 8 were the first investigators to introduce open stereotactic craniotomy, which was then enjoyed broader applications and further refinements owing to the advances in the field of medical imaging such as computerized tomography 9 and magnetic resonance imaging 10 .…”

Section: Introductionmentioning

confidence: 99%

CT-guided Stereotactic Microsurgical Resection of Cerebral Mass Lesions

Erşahin¹,

Gürbüz²,

Karaarslan³

et al. 2018

MMJ

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“…Stereotactic surgery for the treatment of psychiatric and neurological disorders was pioneered by Spiegel and Wycis [1]. In their monograph from 1962, they mentioned groups from different countries who had also adopted stereoencephalotomy, and Fritz Roeder and Hans Orthner, two professors of neurology from Göttingen, range among the most frequently cited authors [2].…”

Section: Introductionmentioning

confidence: 99%

The Pioneering and Unknown Stereotactic Approach of Roeder and Orthner from Göttingen. Part I. Surgical Technique for Tailoring Individualized Stereotactic Lesions

Hamel¹,

Köppen²,

Hariz³

et al. 2016

Stereotact Funct Neurosurg

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During the 1950s through the 1970s, Hans Orthner and Fritz Roeder, two German neurologists from Göttingen, developed a sophisticated technique to perform functional stereotactic surgery with outstanding accuracy. They introduced direct air ventriculography performed in the same surgical session as the ablative stereotactic procedure. For individualized surgical targeting, Orthner prepared a stereotactic atlas (>60 brains) with an ingenious brain-slicing device, the Göttinger macrotome. Brains were grouped based on similarity of six different head and ventricle measurements. A brain cluster representing the best match for a patient was selected for stereotactic targeting. Stereotactic lesions were tailored in an individual manner and shaped by stringing together multiple small coagulations following intraoperative test stimulation. This was achieved from a single probe trajectory by using well-engineered string electrodes with calibrated curving and involved laborious calculations. Only high-frequency thermocoagulation was regarded as appropriate for lesioning. With this meticulous technique, the most advanced stereotactic procedures were performed, including bilateral pallidotomy that ultimately could be restricted to the ansa lenticularis and ventromedial hypothalamotomy, the most delicate stereotactic operation performed to date. Outside Göttingen, this technique has only been used by Prof. Dieter Müller in Hamburg, Germany. This elaborate stereotactic approach is widely unknown and deserves to be discussed in a historical context.

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Stereotaxic Apparatus for Operations on the Human Brain

Cited by 872 publications

References 1 publication

Analysis of Stereotactic Accuracy in Patients Undergoing Deep Brain Stimulation Using Nexframe and the Leksell Frame

Analysis of Stereotactic Accuracy in Patients Undergoing Deep Brain Stimulation Using Nexframe and the Leksell Frame

CT-guided Stereotactic Microsurgical Resection of Cerebral Mass Lesions

The Pioneering and Unknown Stereotactic Approach of Roeder and Orthner from Göttingen. Part I. Surgical Technique for Tailoring Individualized Stereotactic Lesions

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