在清醒,机器人深度大脑刺激患者中,转移错误和肺脑病
Sibi Rajendran1,2, Lokeshwar S Bhenderu1,2,3, Jesus G Cruz-Garza1,2
1Department of Neurological Surgery, Houston Methodist Hospital, Houston , Texas , USA.
Operative neurosurgery (Hagerstown, Md.)
|June 3, 2025
概括
在清醒的机器人辅助深度大脑刺激 (DBS) 中,右侧位显示出增加的错误,但肺脑体积与位错位没有相关性. 需要进一步的研究来优化DBS的治疗效益.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 深度大脑刺激 (DBS) 引领位置的准确性对于治疗疗效至关重要,误差>2毫米会影响结果.
- 在DBS期间,位和大脑转移的机制尚未完全理解.
- 麻醉和手术技术的变化使错误归因变得复杂.
研究的目的:
- 为了研究肺脑病和在清醒状态下,机器人辅助的DBS手术中导致转移错误之间的关系.
- 为了比较双边DBS程序中左侧和右侧之间的置精度.
主要方法:
- 包括76名接受VIM或STN目标清醒,机器人辅助DBS的患者.
- 双边领先的放置是顺序执行的 (左然后右).
- 手术后立即使用立体CT扫描来比较计划目标与实际领先位置,并测量肺脑体积.
主要成果:
- 所有患者都表现出一定程度的肺脑病 (平均18.9±15.8厘米3).
- 与STN和VIM目标相比,与左侧的线索相比,右侧的线索显示出明显更大的放置错误 (中位移) (P < .01).
- 没有发现总肺脑体积和错位的大小之间有显著的相关性.
结论:
- 醒着的机器人辅助DBS程序可能会遇到位错误,特别是在右侧.
- 肺脑病,虽然始终存在,但在本研究中与错位的程度没有直接相关.
- 解决系统错误和了解肺脑病的作用是优化DBS结果的关键.
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