Deep Brain Stimulation Lead Implantation Using a Customized Rapidly Manufactured Stereotactic Fixture with Submillimetric Euclidean Accuracy
Deep Brain Stimulation Lead Implantation Using a Customized Rapidly Manufactured Stereotactic Fixture with Submillimetric Euclidean Accuracy
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DOI：
10.1159/000506959
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发表时间：
2020-08-01
影响因子：
1.7
通讯作者：
Neimat, Joseph S.
中科院分区：
文献类型：
--
作者：
Ball, Tyler J.;John, Kevin D.;Neimat, Joseph S.
背景资料：microTargeting（TM）Microtable（TM）平台是一种新型立体定向系统，其制造速度比目前可用的3D打印替代品更快。我们介绍了第一个病例系列的患者接受脑深部电刺激（DBS）手术的指导下，该平台，并证明其在体内的准确性。方法：10例患者由资深作者在一家机构接受了DBS，植入了15根电极导线。平均年龄为69.1岁; 4例为女性。特发性震颤患者靶向腹中间核，帕金森病患者靶向丘脑底核。结果：对6例患者的9根DBS电极导线进行了适当成像，以测量准确度。平均欧几里得电极放置误差（EPE）为0.97 +/- 0.37 mm，平均径向误差为0.80 +/- 0.41 mm（n = 9）。在术后超过1个月进行的CT扫描子集中（n = 3），平均欧几里得EPE为0.75 +/- 0.17 mm，平均径向误差为0.69 +/- 0.17 mm。无手术并发症。结论：Microtable（TM）平台能够在接受立体定向手术的患者中实现亚毫米级精度。它在我们的患者中实现了临床有效性，无手术并发症，并且与传统的立体定向框架和其他常见的无框架系统相比，具有上级准确性的潜力。(c)2020年南Karger AG，巴塞尔
Background: The microTargeting(TM) Microtable(TM) Platform is a novel stereotactic system that can be more rapidly fabricated than currently available 3D-printed alternatives. We present the first case series of patients who underwent deep brain stimulation (DBS) surgery guided by this platform and demonstrate its in vivo accuracy. Methods: Ten patients underwent DBS at a single institution by the senior author and 15 leads were placed. The mean age was 69.1 years; four were female. The ventralis intermedius nucleus was targeted for patients with essential tremor and the subthalamic nucleus was targeted for patients with Parkinson's disease. Results: Nine DBS leads in 6 patients were appropriately imaged to enable measurement of accuracy. The mean Euclidean electrode placement error (EPE) was 0.97 +/- 0.37 mm, and the mean radial error was 0.80 +/- 0.41 mm (n = 9). In the subset of CT scans performed greater than 1 month postoperatively (n = 3), the mean Euclidean EPE was 0.75 +/- 0.17 mm and the mean radial error was 0.69 +/- 0.17 mm. There were no surgical complications. Conclusion: The Microtable(TM) platform is capable of submillimetric accuracy in patients undergoing stereotactic surgery. It has achieved clinical efficacy in our patients without surgical complications and has demonstrated the potential for superior accuracy compared to both traditional stereotactic frames and other common frameless systems. (c) 2020 S. Karger AG, Basel