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Method to perform safety stereotactic procedures in children under 2 years of age
Ramiro J Del Rio1, Roberto O Gonzalez2, R Jaimovich2
1National Hospital of Pediatrics "Prof. Dr. Juan P. Garrahan", Combate de los Pozos 1881, C1245AAM, Buenos Aires, Argentina. rjdelrio@gmail.com.
Insights
This study introduces a safe method for pediatric stereotactic procedures in children under two years old. The adapted technique successfully obtained biopsy samples without any complications.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Devices
Background:
- Stereotactic procedures are established neurosurgical techniques.
- Fixating stereotactic frames in pediatric patients requires special care due to underdeveloped skull bones.
- Potential complications can arise from frame fixation in young children.
Purpose of the Study:
- To present an adapted stereotactic frame fixation method for children under two years of age.
- To evaluate the safety and efficacy of this modified technique in pediatric neurosurgery.
Main Methods:
- A modified Micromar frame was used in twelve procedures on patients under 24 months.
- The frame was adapted with a posterior gauss pillow for head support.
- Four fixation pins were applied without adjustment, and patient data were analyzed.
Main Results:
- Twelve stereotactic procedures were performed on eleven patients aged 9 to 22 months.
- Histopathology analysis confirmed positive results in 11 out of 12 biopsy samples.
- No intraoperative or postoperative complications were reported.
Conclusions:
- The adapted stereotactic frame fixation method is safe and effective for pediatric neurosurgery in patients under two years old.
- This technique minimizes risks associated with skull bone immaturity.
- The study highlights a simple yet crucial adaptation for stereotactic procedures in infants.
Introduction:
Stereotactic procedures have been used in neurosurgery for many years. In children especially, care should be considered to avoid complication caused by fixation of the frame in a not fully developed skull bone. We present our method to adapt the frame in children under 2 years of age.
Methods:
Twelve procedures in patients under 24 months were performed between 2003 and 2015. Micromar frame was used. It was adapted with a small pillow made of gauss attached to the posterior part to hold the head, then four pins were fixed without adjustment. We analyze for each patient age, indication, histopathology, and complications.
Results:
Eleven patients with a mean age of 13.5 months (range 9 to 22 months) underwent 12 stereotactic procedures. In all cases, biopsy samples were obtained, histopathology was positive in 11/12 cases. No complications occurred.
Conclusion:
Stereotactic frame procedures need special attention in small children where the skull bones are not fully developed. We present a simple method to perform this surgery in patients under 2 years of age.
