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用于脑深部电刺激手术的Leksell Vantage立体定向系统的靶向准确性:一项回顾性研究。

Targeting Accuracy of the Leksell Vantage Stereotactic System for Deep Brain Stimulation Surgery: A Retrospective Review.

作者信息

Phillips Katharine R, Mackel Charles E, Alterman Ron L

机构信息

Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Oper Neurosurg (Hagerstown). 2023 Jun 1;24(6):602-609. doi: 10.1227/ons.0000000000000670. Epub 2023 Apr 11.

Abstract

BACKGROUND

Compared with the Leksell G frame, the new Leksell Vantage stereotactic headframe offers many benefits during deep brain stimulation (DBS) procedures.

OBJECTIVE

To define the "real-world" targeting accuracy of the Vantage frame for performing DBS lead implants.

METHODS

Retrospective review of all patients who underwent DBS using the Vantage frame with our surgeon between July 2021 and May 2022. Target and actual coordinates of implanted DBS leads were determined in BrainLab.

RESULTS

Thirty-three electrode trajectories (17 left-sided, 16 right-sided) were included. On the right, actual electrode placement was, on average, 0.95 mm more medial, 1.06 mm more posterior, and 0.55 mm more superior compared with planned trajectories. The vector error was 1.93 ± 0.91 mm. On the left, actual electrode placement was 0.49 mm more lateral, 0.66 mm more posterior, and 0.67 mm more superior than planned trajectories. The vector error was 1.68 ± 0.66 mm. After excluding all electrodes that were repositioned after microelectrode recording and/or test stimulation, right-sided electrodes (n = 10) were 0.88 mm more medial, 0.94 mm more posterior, and 0.76 mm more superior than planned trajectories. The vector error was 1.74 ± 1.01 mm. Left-sided electrodes (n = 14) were 0.49 mm more lateral, 0.63 mm more posterior, and 0.49 mm more superior than planned trajectories. The vector error was 1.62 ± 0.68 mm.

CONCLUSION

This study demonstrated the accuracy of the Leksell Vantage frame in comparison with the traditional Leksell G frame.

摘要

背景

与Leksell G型立体定向头架相比,新型Leksell Vantage立体定向头架在脑深部电刺激(DBS)手术过程中具有诸多优势。

目的

确定Vantage头架在进行DBS电极植入时的“实际应用”靶向精度。

方法

回顾性分析2021年7月至2022年5月期间使用Vantage头架与我们的外科医生进行DBS手术的所有患者。在BrainLab中确定植入的DBS电极的靶点和实际坐标。

结果

纳入33条电极轨迹(左侧17条,右侧16条)。在右侧,与计划轨迹相比,实际电极放置平均在内侧多0.95mm、在后方多1.06mm、在上方多0.55mm。矢量误差为1.93±0.91mm。在左侧,实际电极放置比计划轨迹在外侧多0.49mm、在后方多0.66mm、在上方多0.67mm。矢量误差为1.68±0.66mm。在排除所有在微电极记录和/或测试刺激后重新定位的电极后,右侧电极(n = 10)比计划轨迹在内侧多0.88mm、在后方多0.94mm、在上方多0.76mm。矢量误差为1.74±1.01mm。左侧电极(n = 14)比计划轨迹在外侧多0.49mm、在后方多0.63mm、在上方多0.49mm。矢量误差为1.62±0.68mm。

结论

本研究证明了Leksell Vantage头架相较于传统Leksell G头架的准确性。

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