Atteya Mostafa M E
Neurosurgery Department, Children's Cancer Hospital, Egypt (CCHE-57357), Cairo, Egypt.
Neurosurgery Department, Faculty of Medicine, Helwan University, Helwan, Egypt.
Childs Nerv Syst. 2020 Jan;36(1):179-187. doi: 10.1007/s00381-019-04390-y. Epub 2019 Nov 9.
Modern neurosurgery is nowadays based on technological advances. Intra-operative image guidance systems are frequently utilized in the everyday neurosurgical practice. Frameless stereotactic procedures (FSPs) require a great deal of technical abilities and precautions. Frameless stereotaxy mandates a high degree of problem-solving attitude and on-the-spot neurosurgeon's creativity.
In these technical notes, the author aims at presenting his experience in frameless stereotaxy for more than 10 years in the form of easily digestible tricks and pitfalls during every step of FSPs.
The author retrospectively distilled the tricks and pitfalls of the FSPs performed by him during the past 10 years according to their chronological status in a how-I-do-it fashion.
Chronologically speaking, phases relating to any FSP were divided into five phases: (1) preoperative image acquisition, (2) pre-operative planning, (3) machine setup, positioning, and registration; (4) operative techniques; and (5) post-operative precautions. Faults in any of these phases can result in failure of the procedure or in faulty surgery with subsequent complications. Each stage is addressed in a how I do it fashion, questions and answers, bulleted or numbered tricks and pitfalls, and, in some instances, what-to-do-if scenarios were given.
Frameless stereotaxy is a well-established neurosurgical practice. Many neurosurgeons are only aware with the bare minimum of the technical aspects of frameless stereotaxy and, subsequently, they practice the bare minimum of its applications. FSPs entail a great deal of technical tricks and pitfalls. Awareness of these techniques should be the target of every neurosurgeon.
现代神经外科手术如今基于技术进步。术中图像引导系统在日常神经外科手术实践中经常被使用。无框架立体定向手术（FSPs）需要大量的技术能力和预防措施。无框架立体定向要求高度的解决问题的态度和现场神经外科医生的创造力。
在这些技术笔记中，作者旨在以FSPs每个步骤中易于理解的技巧和陷阱的形式呈现他超过10年的无框架立体定向经验。
作者以他如何操作的方式，根据过去10年中FSPs的时间顺序，回顾性地提炼了他所执行的FSPs的技巧和陷阱。
按时间顺序，任何FSP相关的阶段分为五个阶段：（1）术前图像采集，（2）术前规划，（3）机器设置、定位和注册；（4）手术技术；以及（5）术后预防措施。这些阶段中的任何一个出现失误都可能导致手术失败或手术失误并随后引发并发症。每个阶段都以我如何做的方式进行阐述，包括问题与答案、带项目符号或编号的技巧和陷阱，并且在某些情况下给出了如果……该怎么做的场景。
无框架立体定向是一种成熟的神经外科手术实践。许多神经外科医生仅了解无框架立体定向技术方面的最基本内容，随后，他们也只是进行其最基本的应用。FSPs需要大量的技术技巧和陷阱。了解这些技术应该是每个神经外科医生的目标。
