Warnick Ronald E, Yook Eunsun
Mayfield Clinic and the Gamma Knife Center, Jewish Hospital-Mercy Health, 3825 Edwards Road, Suite 300, Cincinnati, OH, USA.
TriHealth Hatton Research Institute, Cincinnati, OH, USA.
J Radiosurg SBRT. 2019;6(3):241-246.
Our retrospective study addresses the largely unknown effect of fixation pin type on depth of skull penetration during Gamma Knife frame placement.
Absolute and relative depths were compared for 404 pins of aluminum and titanium in 101 patients who underwent Gamma Knife frame placement at 0.4 Nm (3.5 lb-in) torque.
Effect of pin type was significant: penetration was less in aluminum than titanium pins, for absolute (0.27 mm vs. 0.83 mm) and relative (5.16% vs. 15.53%) depths (p < 0.001 each). Fifty percent of aluminum pins did not measurably penetrate the outer table of the skull whereas 95% of titanium pins penetrated into cancellous bone.
Although these pin penetration differences did not have a clear clinical correlate, we now recommend titanium pins for their consistent, deeper penetration, which may result in greater frame stability favorable for most clinical applications. Future studies may define optimal torque for aluminum pins.
我们的回顾性研究探讨了固定针类型对伽玛刀框架放置过程中颅骨穿透深度的影响，而这在很大程度上尚不清楚。
对101例行伽玛刀框架放置的患者，在0.4 Nm（3.5磅英寸）扭矩下，比较了404根铝制和钛制固定针的绝对深度和相对深度。
针类型的影响显著：铝制针的穿透深度小于钛制针，绝对深度（0.27毫米对0.83毫米）和相对深度（5.16%对15.53%）均如此（每项p < 0.001）。50%的铝制针未明显穿透颅骨外板，而95%的钛制针穿透至松质骨。
尽管这些针的穿透差异没有明确的临床关联，但我们现在推荐使用钛制针，因为其穿透一致且更深，这可能会带来更高的框架稳定性，有利于大多数临床应用。未来的研究可能会确定铝制针的最佳扭矩。
