Improved accuracy using a modified registration method of ROSA in deep brain stimulation surgery

Area of Science:

• Neurosurgery
• Medical Robotics
• Biomedical Engineering

Background:

• Deep brain stimulation (DBS) is a crucial treatment for movement disorders.
• Accurate electrode placement is vital for DBS efficacy and safety.
• Registration errors can impact surgical precision and patient outcomes.

Purpose of the Study:

• To evaluate a modified registration method for reducing errors in DBS surgery.
• To assess the clinical significance of this modified method using the ROSA system.
• To analyze the correlation between registration error and electrode vector error.

Main Methods:

• Skull models and clinical trials were used to test registration methods with the ROSA system.
• Conventional and modified registration techniques were compared in 33 (group I) and 38 (group II) patients.
• Registration error, electrode vector error, intraoperative electrophysiological signal length (IESL), and DBS power-on voltage were measured.

Main Results:

• The modified registration method significantly reduced registration error (0.27 ± 0.07 mm vs. 0.62 ± 0.22 mm) and electrode vector error (0.65 ± 0.23 mm vs. 0.97 ± 0.31 mm).
• A positive correlation was observed between registration error and electrode vector error in both groups.
• The modified method also led to a significant reduction in DBS power-on voltage (1.48 ± 0.38 V vs. 1.63 ± 0.44 V).

Conclusions:

• The modified registration method effectively decreases registration and electrode vector errors in ROSA-assisted DBS surgery.
• While short-term clinical outcomes (UPDRS scores) were similar, the reduction in surgical errors is a key advancement.
• Further long-term evaluation is necessary to fully understand the clinical impact of the modified registration technique.