Localization of precentral gyrus in image-guided surgery for motor cortex stimulation

Area of Science:

• Neurosurgery
• Pain Management

Background:

• Motor cortex stimulation (MCS) is an emerging treatment for central pain syndromes.
• Minimally invasive techniques are crucial for improving patient outcomes in neurosurgery.

Purpose of the Study:

• To present a minimally invasive surgical technique for motor cortex stimulation electrode placement.
• To evaluate the clinical utility of neuronavigation and vacuum headrest in MCS surgery.

Main Methods:

• Image guidance with neuronavigation for precentral gyrus identification and surgical planning.
• Single burr-hole approach and intraoperative confirmation using somatosensory evoked potentials (SSEP) and electrical stimulation.
• Postoperative clinical and neuroradiological assessments.

Main Results:

• Neuronavigation ensured accurate localization of the precentral gyrus.
• Successful electrode placement was achieved in all cases.
• All patients reported significant postoperative pain relief.

Conclusions:

• Image guidance is a valuable tool for accurate and safe motor cortex stimulation surgery.
• A minimally invasive approach using a single burr-hole and vacuum headrest is effective for MCS procedures.