Accuracy and clinical outcomes of robot-assisted deep brain stimulation lead placement using a floor-mounted robotic navigation system: a prospective multicenter study
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Published on: May 11, 2020
Francisco A Ponce1, Arnold Vardiman2, Markey Olson1
11Department of Functional Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona; and.
Objective:
The aim of this study was to evaluate clinical data to assess the accuracy and safety of a new robot system used for deep brain stimulation (DBS) lead placement.
Methods:
A prospective, multicenter, single-arm study included 60 patients indicated for DBS. Patients aged 18-85 years with Parkinson's disease, essential tremor, or dystonia were enrolled. The primary outcome was electrode accuracy at the tip, 40 mm from the tip, and the entry point compared with the planned trajectory. Secondary outcomes included operative time (OT), length of stay (LOS), and perioperative complications through discharge.
Results:
The cohort (mean age 67.1 ± 9.9 years) primarily consisted of patients with Parkinson's disease (n = 46). The mean OT was 159.0 ± 26.7 minutes, and the mean LOS was 1.6 ± 1.5 days. The complication rate and return to the operating room rate were both 0%. The mean tip error was 0.8 ± 0.5 mm, error at 40 mm from the tip was 0.4 ± 0.5 mm, and entry point error was 1.0 ± 0.8 mm.
Conclusions:
DBS electrode implantation using the new robot-assisted system demonstrated high plan-to-place accuracy comparable or superior to historical frame-based and robotic platforms. The safety profile and operative efficiency, reflected by very low complication rates and similar OT and LOS to published literature, support the system as a viable alternative to standard frame-based stereotaxy.
