Department of Neurosurgery, Wessex Neurological Centre, Southampton University Hospitals Trust, Southampton, United Kingdom.
Neurosurgery. 2012 Mar;70(1 Suppl Operative):29-33; discussion 33. doi: 10.1227/NEU.0b013e31822d75af.
In recent years, frameless navigation techniques have been reported to be safe and effective for biopsy of cerebral lesions.
To evaluate the safety and efficacy of a technique of frameless, pinless electromagnetic-guided biopsy for brain lesions with the Medtronic Stealth AxiEM.
Prospective data were collected on consecutive brain biopsies performed by a single surgeon (P.L.G.) with this technology between October 2007 and May 2010. One trajectory was made per lesion with multiple specimens taken for analysis. Outcome measures included measures of accuracy, histological yield, and complication rate.
A total of 150 biopsies were performed in 149 patients (84 male and 65 female patients; age range, 19.8-83.8 years). The consultant performed 49 procedures, supervising a trainee in the others. In only 1 case (0.7%) was there nondiagnosis consequent of a registration error and inaccurate trajectory. In 4 other cases (2.7%), no specific diagnosis was established, but abnormal tissue was identified histologically, and postoperative imaging confirmed accurate targeting of these lesions. There were no instances of intracranial hemorrhage or significant morbidity and no deaths directly attributable to the procedure. Four patients (2.7%) died within 30 days of the procedure but not of complications of surgery. One patient suffered a transitory neurological deficit.
Electromagnetic navigation is proven to be a simple, safe, and effective innovation for frameless and pinless biopsy of cerebral lesions. This technique is time efficient, and elimination of frame placement enhances patient comfort and facilitates the use of local anesthetic technique.
近年来，无框架导航技术已被报道用于脑病变活检是安全且有效的。
评估无框架、无针电磁引导活检技术用于 Medtronic Stealth AxiEM 治疗脑病变的安全性和有效性。
前瞻性收集 2007 年 10 月至 2010 年 5 月间由一位外科医生（P.L.G.）应用该技术完成的连续脑活检的临床资料。每个病变部位做一条入路，取多个标本进行分析。主要评估指标包括准确性、组织学检出率和并发症发生率。
共对 149 例患者（84 例男性，65 例女性；年龄 19.8-83.8 岁）的 150 例病变进行了活检。顾问进行了 49 例手术，其余由学员协助完成。仅 1 例（0.7%）因注册错误和轨迹不准确导致诊断不明确。在另外 4 例（2.7%）中，未建立特定诊断，但组织学上识别出异常组织，术后影像学证实这些病变的靶向准确。无颅内出血或严重发病率，无直接归因于手术的死亡病例。4 例患者（2.7%）在手术后 30 天内死亡，但不是手术并发症导致。1 例患者出现短暂性神经功能缺损。
电磁导航被证明是一种用于脑病变无框架、无针活检的简单、安全、有效的创新技术。该技术省时，消除了框架的放置，提高了患者的舒适度，并方便了局部麻醉技术的应用。
