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O-Arm Stereotactic Imaging in Deep Brain Stimulation Surgery Workflow: A Utility and Cost-Effectiveness Analysis
Luciano Furlanetti1, Harutomo Hasegawa2, Anna Oviedova2
1Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, United Kingdom, furlanettil@gmail.com.
Stereotactic and Functional Neurosurgery
|December 1, 2020
Summary
The Medtronic O-arm device improves deep brain stimulation (DBS) surgery by reducing imaging time, radiation exposure, and costs compared to standard MRI/CT. This advanced imaging enhances surgical efficiency and patient safety in movement disorder treatments.
Area of Science:
- Neurosurgery
- Medical Imaging
- Neurology
Background:
- Deep brain stimulation (DBS) is a key treatment for movement disorders.
- Advances in neuroimaging enhance targeting accuracy and clinical outcomes.
- Intraoperative imaging is crucial for precise DBS electrode placement.
Purpose of the Study:
- To evaluate the safety and feasibility of the Medtronic O-arm for intraoperative stereotactic imaging in DBS surgery.
- To compare the O-arm's performance with standard stereotactic MRI or CT for targeting and localization.
- To assess the impact of O-arm imaging on surgical efficiency and resource utilization.
Main Methods:
- Prospective study involving patients undergoing frame-based stereotactic DBS surgery.
- Utilized the Medtronic O-arm for intraoperative imaging to guide and verify electrode placement.
- Compared O-arm imaging acquisition, localization accuracy, surgical time, radiation exposure, and costs against conventional MRI/CT.
Main Results:
- O-arm imaging reduced overall surgical time by 68 minutes and image acquisition time by 77%.
- Patient exposure to ionizing radiation decreased by 24.2% with O-arm use.
- Operating room costs were reduced by 31%, with increased availability of OR and neuroradiology suites.
Conclusions:
- The O-arm significantly reduces imaging time, radiation exposure, and costs in DBS surgery.
- O-arm imaging maintains accuracy comparable to standard MRI/CT for electrode placement.
- The O-arm is a safe and feasible tool for enhancing DBS surgical workflow and efficiency.
