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O-Arm Navigated Frameless and Fiducial-Less Deep Brain Stimulation
David Krahulík1, Martin Nevrlý2, Pavel Otruba2
1Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, 77900 Olomouc, Czech Republic.
Brain Sciences
|September 30, 2020
Summary
This study shows that using the Nexframe system with an O-arm for deep brain stimulation (DBS) electrode placement in Parkinson's disease (PD) is accurate and feasible. The frameless, fiducial-less method achieved precise results comparable to existing techniques.
Area of Science:
- Neurosurgery
- Medical Technology
- Neurology
Background:
- Deep brain stimulation (DBS) is a key treatment for Parkinson's disease (PD), essential tremor, and dystonia.
- Accurate electrode placement is crucial for effective DBS therapy.
Purpose of the Study:
- To evaluate the accuracy of a novel frameless and fiducial-less system (Nexframe™) for DBS electrode placement.
- To assess the feasibility and accuracy of using an intraoperative O-arm™ navigated system in PD patients.
Main Methods:
- Prospective evaluation in eleven consecutive PD patients (22 electrodes).
- Utilized Nexframe™ system with intraoperative O-arm™ and StealthStation™ S8 navigation.
- Accuracy assessed via intraoperative O-arm imaging, microelectrode recording of the subthalamic nucleus (STN), and postoperative CT scans.
Main Results:
- The total procedural error was 1.79 mm.
- Radial and vector errors were 171 mm and 163 mm, respectively.
- Accuracy was confirmed across all three evaluation steps.
Conclusions:
- O-arm navigated, frameless, fiducial-less DBS electrode implantation using Nexframe™ is technically feasible and accurate.
- The procedure is well-tolerated by patients and yields results comparable to published data.
- This method offers a viable alternative for DBS surgery in PD and other movement disorders.
