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对2岁以下儿童进行安全立体定向手术的方法。

Method to perform safety stereotactic procedures in children under 2 years of age.

作者信息

Del Rio Ramiro J, Gonzalez Roberto O, Jaimovich R

机构信息

National Hospital of Pediatrics "Prof. Dr. Juan P. Garrahan", Combate de los Pozos 1881, C1245AAM, Buenos Aires, Argentina.

出版信息

Childs Nerv Syst. 2018 Mar;34(3):555-558. doi: 10.1007/s00381-017-3624-6. Epub 2017 Oct 23.

DOI:10.1007/s00381-017-3624-6
PMID:29063265
Abstract

INTRODUCTION

Stereotactic procedures have been used in neurosurgery for many years. In children especially, care should be considered to avoid complication caused by fixation of the frame in a not fully developed skull bone. We present our method to adapt the frame in children under 2 years of age.

METHODS

Twelve procedures in patients under 24 months were performed between 2003 and 2015. Micromar frame was used. It was adapted with a small pillow made of gauss attached to the posterior part to hold the head, then four pins were fixed without adjustment. We analyze for each patient age, indication, histopathology, and complications.

RESULTS

Eleven patients with a mean age of 13.5 months (range 9 to 22 months) underwent 12 stereotactic procedures. In all cases, biopsy samples were obtained, histopathology was positive in 11/12 cases. No complications occurred.

CONCLUSION

Stereotactic frame procedures need special attention in small children where the skull bones are not fully developed. We present a simple method to perform this surgery in patients under 2 years of age.

摘要

引言

立体定向手术已在神经外科应用多年。尤其是对于儿童,应特别注意避免因在未完全发育的颅骨上固定框架而引起并发症。我们介绍了一种适用于2岁以下儿童的框架适配方法。

方法

2003年至2015年间,对24个月以下的患者进行了12例手术。使用了Micromar框架。用一块由高斯材料制成的小枕头连接到框架后部来固定头部,然后直接固定四根针,无需调整。我们对每位患者的年龄、适应症、组织病理学和并发症进行了分析。

结果

11例平均年龄为13.5个月(范围9至22个月)的患者接受了12次立体定向手术。所有病例均获取了活检样本,12例中有11例组织病理学呈阳性。未发生并发症。

结论

在颅骨未完全发育的幼儿中,立体定向框架手术需要特别关注。我们提出了一种在2岁以下患者中进行该手术的简单方法。

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本文引用的文献

1
Biopsy in a series of 130 pediatric diffuse intrinsic Pontine gliomas.130例儿童弥漫性脑桥内在型胶质瘤的活检
Childs Nerv Syst. 2015 Oct;31(10):1773-80. doi: 10.1007/s00381-015-2832-1. Epub 2015 Sep 9.
2
Frame-based stereotactic neurosurgery in children under the age of seven: Freiburg University's experience from 99 consecutive cases.7岁以下儿童的基于框架的立体定向神经外科手术:弗莱堡大学连续99例病例的经验。
Clin Neurol Neurosurg. 2015 Mar;130:42-7. doi: 10.1016/j.clineuro.2014.12.011. Epub 2014 Dec 30.
3
Use of cranial fixation pins in pediatric neurosurgery.
颅骨固定针在小儿神经外科手术中的应用。
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Adaptation of skull clamp for use in image-guided surgery of children in the first 2 years of life.适用于2岁以下儿童影像引导手术的颅骨夹
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Roentgenological skull measurements and their diagnostic applications.X线颅骨测量及其诊断应用。
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Technique of stereotactic biopsy in a 5-month-old child.
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Depressed skull fractures in children secondary to skull clamp fixation devices.儿童因颅骨夹固定装置导致的凹陷性颅骨骨折。
Pediatr Neurosurg. 1994;21(3):174-7; discussion 178. doi: 10.1159/000120830.
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Stereotactic biopsy of brain tumors.脑肿瘤的立体定向活检
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A biomechanical analysis of halo fixation in children.
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Helmet for infant skull fixation during stereotactic neurosurgery.用于立体定向神经外科手术中固定婴儿颅骨的头盔。
Appl Neurophysiol. 1987;50(1-6):114-8. doi: 10.1159/000100694.