Computer aided surgery : official journal of the International Society for Computer Aided Surgery
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Comput. Aided Surg. · Jan 2002
Comparative StudyThe application accuracy of the NeuroMate robot--A quantitative comparison with frameless and frame-based surgical localization systems.
The NeuroMatetrade mark robot system (Integrated Surgical Systems, Davis, CA) is a commercially available, image-guided, robotic-assisted system used for stereotactic procedures in neurosurgery. In this article, we present a quantitative comparison of the application accuracy of the NeuroMate with that of standard frame-based and frameless stereotactic techniques. ⋯ The study was performed with 2-mm sections of CT scans. These results show that the application accuracy of the frame-based NeuroMate robot is comparable to that of standard localizing systems, whether they are frame-based or infrared tracked.
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The objective of this study was to develop, demonstrate, and validate a remotely controlled operation scheme coupled with prospective magnetic resonance imaging (MRI)-based stereotaxy for in vivo neurosurgical applications. The novel concept of the prospective guidance scheme is to employ tomographical imaging feedback, such as MRI or CT, to facilitate prospectively the targeting process of a biopsy needle at near-real-time speed (1 image/s). Because the orientation of a biopsy needle pivoted at an entry point on the patient's skull has 2 degrees of freedom, the alignment of its trajectory to a target point can be guided by two-dimensional (2D) images whose plane is placed perpendicular to the desired trajectory. ⋯ The actual targeting error was 1.53 +/- 0.17 mm from an intended target location, with the maximum distance error of 1.72 mm at a depth of 85 mm. This remotely controlled surgical approach with intraoperative MRI guidance is feasible at 1.5 T, and has allowed neurosurgeons to perform neurobiopsies comfortably and efficiently in a routine clinical MR scanner. This scheme provides a unique alternative stereotactic procedure that can take full advantage of the prospective guidance potential offered by various modern tomographic imaging systems.
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Comput. Aided Surg. · Jan 2002
Closed reduction and percutaneous fixation of anterior column acetabular fractures.
The current standard treatment of anterior column acetabular fractures includes formal open reduction with internal fixation (ORIF) through a variety of anterior approaches. These approaches have been associated with significant blood loss, infection, lengthy operative times, and neurovascular complications. It therefore seems reasonable to consider less invasive alternatives to conventional treatment methods. A technique for percutaneous reduction and fixation of a particular acetabular fracture pattern is presented. Execution of this technique has been facilitated by the use of image-guided surgical navigation. ⋯ We believe that our findings substantiate percutaneous reduction and internal fixation of anterior column acetabular fractures as a safe and effective alternative to formal ORIF, with a low anticipated complication rate and excellent outcome.
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Comput. Aided Surg. · Jan 2002
Comparative StudyComparison of functional brain PET images and intraoperative brain-mapping data using image-guided surgery.
Knowledge about the spatial localization of eloquent brain areas is essential for resecting lesions in the vicinity of these areas. The classical approach is to perform surgery on the awake patient under local anesthesia using brain-mapping techniques. As an alternative, the location of eloquent areas can be visualized by preoperative functional brain-imaging techniques, for example, positron emission tomography (PET), functional magnetic resonance imaging (fMRI), or magnetoencephalography (MEG). Using functional activation PET, both methods were combined by integration into a frameless navigation system (BrainLAB) and used to map speech-eloquent areas. ⋯ This matching and mapping technique is suitable for monitoring eloquent speech areas during surgical resection of extensive left-sided low-grade gliomas, allowing a direct comparison between intraoperative electrophysiological brain mapping and preoperative functional brain-imaging findings. The sensitivity and specificity of functional imaging techniques can now be evaluated by reconciling the data with the intraoperative stimulation results.