Skip to main content
Top
Published in: Acta Neurochirurgica 11/2012

01-11-2012 | How I Do it

Robotic implantation of deep brain stimulation leads, assisted by intra-operative, flat-panel CT

Authors: M. Lefranc, D. Le Gars

Published in: Acta Neurochirurgica | Issue 11/2012

Login to get access

Abstract

Background

There are two mandatory skills in deep brain stimulation (DBS) neurosurgery: accuracy and control.

Method

Frame-based robotic registration was performed. Prior to insertion into the skull, the guide tube’s position was checked with flat-panel computed tomography (fpCT). After registration against the pre-operative plan, we measured and corrected the robotic arm’s position so that the guide tube with the micro-electrode would follow the planned trajectory exactly. We then used fpCT again to check the DBS lead’s final position.

Conclusion

The combination of intra-operative fpCT with robotised surgery provides an appropriate, user-friendly solution to the key technical challenges in DBS lead implantation.
Appendix
Available only for authorised users
Literature
1.
go back to reference Benabid A-L, Chabardes S, Mitrofanis J, Pollak P (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 8:67–81PubMedCrossRef Benabid A-L, Chabardes S, Mitrofanis J, Pollak P (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 8:67–81PubMedCrossRef
2.
go back to reference Blomstedt P, Sandvik U, Linder J, Fredricks A, Forsgren L, Hariz MI (2011) Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor. Acta Neurochir (Wien) 153:2329–2335CrossRef Blomstedt P, Sandvik U, Linder J, Fredricks A, Forsgren L, Hariz MI (2011) Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor. Acta Neurochir (Wien) 153:2329–2335CrossRef
3.
go back to reference Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schäfer H, Bötzel K, Daniels Christine, Deutschländer Angela, Dillmann Ulrich, Eisner Wilhelm, Gruber Doreen, Hamel Wolfgang, Herzog Jan, Hilker Rüdiger, Klebe Stephan, Klob Manja, Koy Jan, Krause Martin, Kupsch Andreas, Lorenz Delia, Stefan Lorenzl H, Mehdorn Maximilian, Moringlane Jean Richard, Oertel Wolfgang, Pinsker Marcus O, Reichmann Heinz, Reub Alexander, Schneider Gerd-Helge, Schnitzler Alfons, Steude Ulrich, Sturm Volker, Timmermann Lars, Tronnier Volker, Trottenberg Thomas, Wojtecki Lars, Wolf Elisabeth, Poewe Werner, Voges Jürgen (2006) A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 355:896–908PubMedCrossRef Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schäfer H, Bötzel K, Daniels Christine, Deutschländer Angela, Dillmann Ulrich, Eisner Wilhelm, Gruber Doreen, Hamel Wolfgang, Herzog Jan, Hilker Rüdiger, Klebe Stephan, Klob Manja, Koy Jan, Krause Martin, Kupsch Andreas, Lorenz Delia, Stefan Lorenzl H, Mehdorn Maximilian, Moringlane Jean Richard, Oertel Wolfgang, Pinsker Marcus O, Reichmann Heinz, Reub Alexander, Schneider Gerd-Helge, Schnitzler Alfons, Steude Ulrich, Sturm Volker, Timmermann Lars, Tronnier Volker, Trottenberg Thomas, Wojtecki Lars, Wolf Elisabeth, Poewe Werner, Voges Jürgen (2006) A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 355:896–908PubMedCrossRef
4.
go back to reference Gupta R, Cheung AC, Bartling SH, Lisauskas J, Grasruck M, Leidecker C, Schmidt B, Flohr T, Brady T (2008) Flat-panel volume CT: fundamental principles, technology, and applications. Radiographics 28:2009–2022PubMedCrossRef Gupta R, Cheung AC, Bartling SH, Lisauskas J, Grasruck M, Leidecker C, Schmidt B, Flohr T, Brady T (2008) Flat-panel volume CT: fundamental principles, technology, and applications. Radiographics 28:2009–2022PubMedCrossRef
5.
go back to reference Hamani C, Saint-Cyr JA, Fraser J, Kaplitt M, Lozano AM (2004) The subthalamic nucleus in the context of movement disorders. Brain 127:4–20PubMedCrossRef Hamani C, Saint-Cyr JA, Fraser J, Kaplitt M, Lozano AM (2004) The subthalamic nucleus in the context of movement disorders. Brain 127:4–20PubMedCrossRef
6.
go back to reference Kall BA (2009) Image reconstruction and fusion. In: Lozano AM, Gildenberg PL, Tasker RL(eds) Textbook of stereotactic and functional neurosurgery. Springer, Berlin Heidelberg, pp 335–343 Kall BA (2009) Image reconstruction and fusion. In: Lozano AM, Gildenberg PL, Tasker RL(eds) Textbook of stereotactic and functional neurosurgery. Springer, Berlin Heidelberg, pp 335–343
7.
go back to reference Petersen EA, Holl EM, Martinez-Torres I, Foltynie T, Limousin P, Hariz MI, Zrinzo L (2010) Minimizing brain shift in stereotactic functional neurosurgery. Neurosurgery 67:213–221, discussion 221CrossRef Petersen EA, Holl EM, Martinez-Torres I, Foltynie T, Limousin P, Hariz MI, Zrinzo L (2010) Minimizing brain shift in stereotactic functional neurosurgery. Neurosurgery 67:213–221, discussion 221CrossRef
8.
go back to reference Schlaier JR, Habermeyer C, Warnat J, Lange M, Janzen A, Hochreiter A, Proescholdt A, Brawanski A, Fellner C (2011) Discrepancies between the MRI- and the electrophysiologically defined subthalamic nucleus. Acta Neurochir (Wein) 153:2307–2318CrossRef Schlaier JR, Habermeyer C, Warnat J, Lange M, Janzen A, Hochreiter A, Proescholdt A, Brawanski A, Fellner C (2011) Discrepancies between the MRI- and the electrophysiologically defined subthalamic nucleus. Acta Neurochir (Wein) 153:2307–2318CrossRef
9.
go back to reference Tir M, Devos D, Blond S, Touzet G, Reyns N, Duhamel A, Cottencin O, Dujardin K, Cassim F, Destée A, Defebvre L, Krystkowiak P (2007) Exhaustive, one-year follow-up of subthalamic nucleus deep brain stimulation in a large, single-center cohort of parkinsonian patients. Neurosurgery 61:297–304, discussion 304–305PubMedCrossRef Tir M, Devos D, Blond S, Touzet G, Reyns N, Duhamel A, Cottencin O, Dujardin K, Cassim F, Destée A, Defebvre L, Krystkowiak P (2007) Exhaustive, one-year follow-up of subthalamic nucleus deep brain stimulation in a large, single-center cohort of parkinsonian patients. Neurosurgery 61:297–304, discussion 304–305PubMedCrossRef
10.
go back to reference Zhang J, Weir V, Fajardo L, Lin J, Hsiung H, Ritenour ER (2009) Dosimetric characterization of a cone-beam O-arm imaging system. J Xray Sci Technol 17:305–317PubMed Zhang J, Weir V, Fajardo L, Lin J, Hsiung H, Ritenour ER (2009) Dosimetric characterization of a cone-beam O-arm imaging system. J Xray Sci Technol 17:305–317PubMed
Metadata
Title
Robotic implantation of deep brain stimulation leads, assisted by intra-operative, flat-panel CT
Authors
M. Lefranc
D. Le Gars
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Acta Neurochirurgica / Issue 11/2012
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-012-1445-7

Other articles of this Issue 11/2012

Acta Neurochirurgica 11/2012 Go to the issue