Biceroglu Huseyin, Akbulut Bilal Bahadir, Derin Okan, Akbulut Ozde Senol, Boluk Mustafa Serdar, Akinturk Nevhis, Caliskan Kadri Emre, Eraslan Cenk, Celik Servet, Acarer Ahmet, Yurtseven Taskin
Ege University, Faculty of Medicine, Department of Neurosurgery, Izmir, Türkiye.
Turk Neurosurg. 2025;35(4):580-586. doi: 10.5137/1019-5149.JTN.47419-24.2.
To measure the deviation rate of a custom 3D-printed Deep Brain Stimulation (DBS) lead holder assisted electrode placements from their intended targets, providing a benchmark for the system?s accuracy and paving the way for its use in standard DBS workflows.
The study was conducted in an experimental lab using a cadaver obtained according to local regulations. Planned electrode trajectories, designed with Medtronic?s DBS surgery planning system, were transferred to the StealthStation Autoguide. A 3D-printed DBS lead holder with integrated navigation fiducials was used to place six electrodes in the targeted brain regions. Pre-operative CT and MRI scans were used for planning, and post-operative imaging confirmed electrode placement. Deviation from planned trajectories was analyzed using Python to assess accuracy.
Following a 30-minute registration and draping process, the median electrode placement time was 22.5 minutes (range: 15-120). The total surgical time for all six electrodes was approximately 5 hours, including imaging, adjustments, and confirmation. The median difference was 1.73 mm (0.03-5.45) on the X-axis, 1.86 mm (0.46-2.74) on the Y-axis, and 1.95 mm (0.73-4.4) on the Z-axis. The median vectorial difference was 2.68 mm (2.3-6.71), while the median trajectory difference was 3.01 mm (1.64-6.63).
Despite 50% of leads having a vectorial difference exceeding 4 mm, most had a trajectory difference of less than 3 mm, which could be attributed to the inability to measure the length of the electrode precisely. These results suggest that with minor adjustments, the StealthStation Autoguide could be a cost-effective alternative to similar systems, though further cadaveric studies are necessary to address potential learning curves and random factors.
测量定制的3D打印深部脑刺激（DBS）导联固定器辅助电极放置与预期靶点的偏差率，为该系统的准确性提供基准，并为其在标准DBS工作流程中的应用铺平道路。
本研究在一个实验实验室中进行，使用了根据当地法规获取的一具尸体。利用美敦力的DBS手术规划系统设计的计划电极轨迹被传输到StealthStation自动导航仪。使用带有集成导航基准的3D打印DBS导联固定器将六个电极放置在目标脑区。术前CT和MRI扫描用于规划，术后成像确认电极放置情况。使用Python分析与计划轨迹的偏差以评估准确性。
经过30分钟的注册和铺巾过程后，电极放置的中位时间为22.5分钟（范围：15 - 120分钟）。所有六个电极的总手术时间约为5小时，包括成像、调整和确认。在X轴上的中位差异为1.73毫米（0.03 - 5.45毫米），在Y轴上为1.86毫米（0.46 - 2.74毫米），在Z轴上为1.95毫米（0.73 - 4.4毫米）。中位矢量差异为2.68毫米（2.3 - 6.71毫米），而中位轨迹差异为3.01毫米（1.64 - 6.63毫米）。
尽管50%的导联矢量差异超过4毫米，但大多数导联的轨迹差异小于3毫米，这可能归因于无法精确测量电极长度。这些结果表明，经过微小调整后，StealthStation自动导航仪可能是类似系统的一种经济高效的替代方案，不过需要进一步的尸体研究来解决潜在的学习曲线和随机因素问题。
