Frameless stereotactic lesion contour-guided surgery using a computer-navigated microscope. Commentary
In: Surgical neurology, Jg. 49 (1998), Heft 3, S. 282-289
academicJournal
- print, 37 ref
Zugriff:
BACKGROUND The Zeiss MKM System is a recently developed computerized operating microscope for image-guided neurosurgery. The clinical advantages, reliability, accuracy, and limitations of this technique were investigated. METHODS Since February 1995, 78 consecutive frameless stereotactic image-guided procedures were performed in 73 patients (30 males, 43 females; mean age, 46.9 years; range, 16-77 years) for tumor surgery (50/64.1%), cavernoma removal (16/20.5%), and functional procedures (12/15.4%). Skin markers (74 cases) or bone markers (4 cases) and a standard imaging protocol (2-mm cranial computed tomography (CCT) in 59 cases/1.5-mm magnetic resonance imaging (MRI) in 19 cases) were used. RESULTS The main advantages were pre-operative skin incision, craniotomy and corticotomy planning, and determination of lesion boundaries. Useful registration and system reliability were noted in 97% (76/78) of the procedures. A significant improvement in registration accuracy was observed over the test period from a mean of 4.8 mm (SD = 3.36; Cases 1-25) to a mean of 2.2 mm (SD = 0.86; Cases 26-78). This resulted in an improvement in application accuracy from <5 mm in 71% (Cases 1-25) to <2 mm in 95% (Cases 26-78) of cases, and the accuracy led to successful localization of the lesion in every case. Accuracy was reliable at the beginning of every procedure, but degraded to values >5 mm by the end of the procedure in 29% (22/78) of cases. MRI cases achieved higher application accuracy values (2.1 mm mean) than CT cases (3.7 mm mean). CONCLUSIONS The system offers a reliable alternative to frame-assisted stereotactic craniotomies in lesion targeting, but would need an intraoperative image update for resection guidance.
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Frameless stereotactic lesion contour-guided surgery using a computer-navigated microscope. Commentary
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Autor/in / Beteiligte Person: | ROESSLER, K ; UNGERSBOECK, K ; AICHHOLZER, M ; DIETRICH, W ; GOERZER, H ; MATULA, C ; CZECH, T ; KOOS, W. T ; ALP, M. S |
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Zeitschrift: | Surgical neurology, Jg. 49 (1998), Heft 3, S. 282-289 |
Veröffentlichung: | New York, NY: Elsevier, 1998 |
Medientyp: | academicJournal |
Umfang: | print, 37 ref |
ISSN: | 0090-3019 (print) |
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