Kamiryo T, Jackson T, Laws E
Department of Neurological Surgery, Virginia Neurological Institute, University of Virginia, Charlottesville, USA.
Minim Invasive Neurosurg. 2000 Mar;43(1):1-3. doi: 10.1055/s-2000-8811.
A series of technical tips and devices designed to increase accuracy and safety in stereotactic surgery are presented. We use stereotactic magnetic resonance imaging with three-dimensional magnetization-prepared rapid gradient-echo (MP-RAGE) imaging to minimize image distortion, and a three-dimensional stereotactic planning system for accurately registering three-dimensional space. We also developed several technical devices useful for stereotactic intracranial procedures; an applicator system attached to the frame which simulates the fiducial markers in order to keep the target at a suitable position in stereotactic space; a torque wrench to set the torque on the fixing pins to the frame reproducibly at 5 inch pounds in order to keep distortion of the frame to a minimum while maintaining secure fixation; an entry point marker to maintain the calculated trajectory angle; a straightening cannula to prevent the thermo-coagulation needle from bending; a microvascular Doppler and its holder to detect significant vessels and to know their precise depth in order to avoid vascular injury from thermocoagulation; a burr hole button device to secure depth electrode cables at the patient's skull.
本文介绍了一系列旨在提高立体定向手术准确性和安全性的技术技巧及设备。我们采用立体定向磁共振成像，结合三维磁化准备快速梯度回波（MP-RAGE）成像，以尽量减少图像失真，并使用三维立体定向规划系统精确注册三维空间。我们还开发了几种用于立体定向颅内手术的技术设备：一种连接到框架上的施药器系统，可模拟基准标记，以便在立体定向空间中将目标保持在合适位置；一种扭矩扳手，可将固定销对框架的扭矩可重复地设置为5英寸磅，以在保持牢固固定的同时将框架变形降至最低；一个入口点标记，用于保持计算出的轨迹角度；一个矫直套管，以防止热凝针弯曲；一个微血管多普勒及其支架，用于检测重要血管并了解其精确深度，以避免热凝造成血管损伤；一个骨孔纽扣装置，用于将深度电极电缆固定在患者颅骨上。
