Pain experience using conventional versus angled anterior posts during stereotactic head frame placement for...

Area of Science:

• Neurosurgery
• Radiation Oncology
• Medical Devices

Background:

• Stereotactic frame placement is essential for radiosurgery.
• Conventional Leksell frame posts may penetrate the temporalis muscle, causing discomfort.
• Angled anterior posts were developed to mitigate this issue.

Purpose of the Study:

• To determine the frequency of angled post use in stereotactic frame placement.
• To quantify the patient pain experience associated with frame placement using angled posts.
• To compare pain levels between patients receiving conventional versus angled posts.

Main Methods:

• Prospective enrollment of 63 patients undergoing radiosurgery.
• Use of angled posts when conventional trajectory risked temporalis muscle penetration.
• Pain scores (0-10) collected at multiple time points: pre-application, post-application, pre-radiosurgery, post-radiosurgery, and 24-hours post-radiosurgery.

Main Results:

• 33 (48%) patients required angled posts.
• Women were significantly more likely than men to require angled posts (60.0% vs. 33.3%, p=0.034).
• Mean pain scores were low (0.33-2.23) with no significant differences between groups.

Conclusions:

• Stereotactic frame placement, even with angled posts, is not perceived as a painful procedure.
• Angled posts effectively avoid temporalis muscle penetration.
• Findings can inform patient counseling regarding frame application pain and post options.