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Intraoperative 3D imaging control during subthalamic Deep Brain Stimulation procedures using O-arm® technology:

F Caire1, D Guehl2, P Burbaud2

  • 1Service de neurochirurgie, CHU de Limoges, 87000 Limoges, France; Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France.

Neuro-Chirurgie
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Summary

Intraoperative 3D imaging during deep brain stimulation (DBS) using the O-arm(®) system allows for accurate electrode placement. This technology helps detect and correct aberrant trajectories early, improving surgical outcomes.

Keywords:
CT scanDeep brain stimulationFunctional neurosurgeryImagerie préopératoireIntraoperative imagingNeuronavigationScannerStimulation cérébrale profonde

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Area of Science:

  • Neurosurgery
  • Medical Imaging

Background:

  • Deep brain stimulation (DBS) is a crucial treatment for movement disorders.
  • Accurate electrode placement is vital for DBS efficacy and safety.
  • Intraoperative imaging can enhance surgical precision.

Purpose of the Study:

  • To evaluate the geometrical accuracy of electrode placement during DBS procedures guided by intraoperative O-arm(®) 3D imaging.
  • To assess the feasibility and utility of intraoperative 3D scans for detecting and correcting electrode misplacement.

Main Methods:

  • Fifteen patients undergoing subthalamic nucleus DBS (STN-DBS) were included.
  • Initial 4 patients had post-procedure 3D scans; the subsequent 11 had intraoperative and post-procedure scans.
  • Electrode positioning accuracy was calculated as the distance between planned and actual placement.

Main Results:

  • The mean electrode positioning accuracy was 1.46±0.56mm for post-procedure scans.
  • For intraoperative scans, mean microelectrode positioning accuracy was 1.59±1.1mm.
  • Definitive electrode accuracy improved to 1.05±0.54mm, with aberrant trajectories identified and corrected in two cases.

Conclusions:

  • Intraoperative 3D scanning with the O-arm(®) is feasible during DBS surgery.
  • This technology aids in the early detection and correction of aberrant electrode trajectories.
  • Intraoperative imaging enhances the precision of DBS lead placement.