Palys Viktoras, Holloway Kathryn L
Prog Neurol Surg. 2018;33:168-186. doi: 10.1159/000481102. Epub 2018 Jan 12.
The stereotactic frame has served as the gold standard apparatus for accurate and precise targeting of deep brain structures since 1947. Despite passing the test of time, the stereotactic frame has several limitations from the perspective of both neurosurgeons and patients. Therefore, there was a need to develop a frameless system that had equivalent accuracy and reliability to the frame. This need was met with 3 commercially available frameless stereotactic systems designed specifically for deep brain stimulation surgery: Nexframe, STarFix, and ClearPoint. Over the past decade, the frameless and frame-based systems have been extensively investigated by numerous studies and found to be equivalent in experimental and clinical accuracy as well as in clinical outcomes. This chapter summarizes the findings of those studies along with the discussion of sources of stereotactic errors. The procedural aspects, advantages, and disadvantages of each frameless system are reviewed. Frameless stereotaxy is a safe, accurate, and effective technique for functional stereotactic approaches and provides a viable alternative to the frame-based systems.
自1947年以来，立体定向框架一直是精确靶向深部脑结构的金标准设备。尽管经受住了时间的考验，但从神经外科医生和患者的角度来看，立体定向框架存在一些局限性。因此，需要开发一种与框架具有同等准确性和可靠性的无框架系统。这种需求通过3种专门为深部脑刺激手术设计的商用无框架立体定向系统得到了满足：Nexframe、STarFix和ClearPoint。在过去十年中，无框架和基于框架的系统已被大量研究广泛调查，并发现它们在实验和临床准确性以及临床结果方面相当。本章总结了这些研究的结果，并讨论了立体定向误差的来源。还回顾了每个无框架系统的操作方面、优点和缺点。无框架立体定向术是一种用于功能性立体定向方法的安全、准确且有效的技术，为基于框架的系统提供了可行的替代方案。
