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Use of the NeuroMate stereotactic robot in a frameless mode for movement disorder surgery
T R K Varma1, P R Eldridge, A Forster
1Walton Centre for Neurology and Neurosurgery, Liverpool, UK. tv.varma@thewaltoncentre.nhs.uk
Background/Aims:
To evaluate the use of the NeuroMate stereotactic robot with a novel ultrasound registration system for movement disorder surgery (MDS).
Methods:
Using the robot in a frameless mode, 51 patients underwent MDS. Surgical planning was carried out using MRI data obtained more than 24 h before surgery.
Results:
37 out of 50 targets in the subthalamic nucleus were satisfactorily identified with a single microelectrode trajectory and the final electrode positions were at a mean distance of 1.7 mm from the calculated target. There was a significant improvement in motor scores of the Unified Parkinson's Disease Rating Scale III (off medication) at 6 (43%) and 18 months (51.7%) compared to pre-operative scores (p < 0.05).
Conclusions:
The frameless robot using only MRI data can be used for MDS. The temporal separation of imaging from the surgical procedure provides additional time for detailed image analysis and planning.
