Analysis of Stereotactic Accuracy of the Cosman-Robert-Wells Frame and Nexframe Frameless Systems in Deep Brain Stimulation Surgery

作者：Kelman Craig; Ramakrishnan V; Davies Alex; Holloway Kathryn^*

来源：Stereotactic and Functional Neurosurgery, 2010, 88(5): 288-295.

DOI：10.1159/000316761

• Stereotactic frame
• Frameless stereotaxy
• Deep brain stimulation
• Parkinson's disease
• Movement disorders
• Target localization
• Functional neurosurgery

Introduction: The primary goal of stereotactic systems in deep brain stimulation (DBS) surgery is accurate delivery of a DBS lead to a target identified on imaging. Thus, it is critical to understand the accuracy of the stereotactic systems and the factors which may be associated with a decrease in accuracy. Methods: Ninety patients underwent microelectrode recording-guided placement of 139 DBS leads by a single surgeon using the Cosman-Roberts-Wells (CRW) frame (n = 70) or a frameless skull-mounted trajectory guide (Nexframe; n = 69). The final DBS location was identified on a postoperative CT fused to the preoperative CT and MRI scans. The difference between this final location and the expected location was calculated. Results: The vector error was 2.65 mm (standard error, 0.22) for the frame and 2.78 mm (standard error, 0.25) for the frameless methods (p = 0.69). There was a gradual decline in error for both systems over time, as the vector error of the last 20 implants was 1.99 for the CRW frame and 2.04 for the Nexframe (p = 0.86). Conclusions: This study shows that the CRW frame and Nexframe frameless systems have equivalent accuracy. Furthermore, the accuracy of both techniques improved over time, from 3 mm initially to 2 mm with current techniques.

• 出版日期2010