Isocentric stereotactic three-dimensional digitizer for neurosurgery

Area of Science:

• Neurosurgery
• Medical Imaging
• Robotics

Background:

• Traditional stereotactic systems often require invasive head fixation.
• Intraoperative spatial monitoring is crucial for precise surgical navigation.
• Advancements in imaging and digitizer technology enable frameless stereotaxy.

Purpose of the Study:

• To introduce a new frameless isocentric stereotactic system integrated with a 3-D digitizer.
• To evaluate the system's accuracy and utility for intraoperative spatial monitoring in neurosurgery.
• To demonstrate the system's applicability in both open and minimally invasive procedures.

Main Methods:

• Development of a frameless isocentric stereotactic mechanism and a multiarticulated 3-D digitizer.
• Integration of external markers (or Laitinen's markers) with CT/MRI for image guidance.
• Real-time spatial coordinate acquisition and matching with pre-operative imaging data.
• System validation through clinical application in open craniotomy and burr hole surgeries.

Main Results:

• The system demonstrated high accuracy, with mechanical errors < 0.8 mm.
• Maximum intraoperative error was estimated not to exceed 2 mm.
• Successfully applied in 22 open craniotomies and 33 burr hole surgeries.

Conclusions:

• The developed frameless stereotactic system provides accurate intraoperative spatial monitoring.
• It is suitable for routine CT/MRI-guided stereotactic surgery, including open procedures.
• The system offers a valuable tool for enhancing precision in neurosurgical interventions.