Accuracy of Deep Brain Stimulation Lead Placement Using a Cranial Robotic Guidance Platform: A Preliminary Cadaveric...

Area of Science:

• Neurosurgery
• Medical Device Engineering
• Biomedical Imaging

Background:

• Deep Brain Stimulation (DBS) is a crucial therapy for neurological disorders.
• Accurate electrode placement is paramount for DBS efficacy and patient safety.
• Current methods for electrode guidance can be costly and complex.

Purpose of the Study:

• To assess the accuracy of a novel 3D-printed DBS lead holder for electrode placement.
• To establish a performance benchmark for this custom system in simulated surgical conditions.
• To evaluate its potential integration into standard DBS surgical workflows.

Main Methods:

• A cadaver model was used to test electrode placement accuracy.
• Planned trajectories were designed using surgical planning software and transferred to a navigation system.
• A 3D-printed holder with integrated fiducials guided the placement of six electrodes.
• Pre- and post-operative imaging (CT/MRI) were used to analyze deviation from planned targets.
• Python was utilized for quantitative deviation analysis.

Main Results:

• Median electrode placement time was 22.5 minutes per electrode, with total procedure time around 5 hours for six electrodes.
• Median deviations were 1.73 mm (X-axis), 1.86 mm (Y-axis), and 1.95 mm (Z-axis).
• Median vectorial difference was 2.68 mm, and median trajectory difference was 3.01 mm.

Conclusions:

• The custom 3D-printed holder demonstrated a trajectory difference generally below 3 mm, indicating good accuracy.
• The system shows promise as a cost-effective alternative to existing DBS guidance systems.
• Further cadaveric studies are recommended to refine the technique and address learning curves.