Perera Doriam, Ramos Pedro Roldán, Valldeoriola Francesc, Sánchez-Gómez Almudena, Ferrés Abel, Pérez-Baldioceda Carlos, Cabrera Gloria, Mosteiro Alejandra, Gómez Lorena, Codes Marta, Manfrelloti Roberto, Rumià Jordi
Service of Neurosurgery, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.
Service of Neurosurgery, Hospital Militar "Dr Alejandro Dávila Bolaños", Managua, Nicaragua.
Acta Neurochir (Wien). 2025 Aug 12;167(1):219. doi: 10.1007/s00701-025-06618-0.
Recently, robotic arms have been incorporated into the implantation of electrodes for deep brain stimulation (DBS).This study aimed to determine the accuracy of brain electrode placement, initial clinical efficacy, and safety profile of the robotic arm Neuromate (Renishaw) compared to a stereotactic frame in movement disorders.
This study involved two retrospective cohorts: one cohort was operated on using a stereotactic frame and the other with a robotic arm. This study was conducted at Barcelona Hospital Clinic.
Seventy-seven patients were included, of whom 30 underwent surgery using the robot and 47 using a stereotactic frame. The postoperative improvement percentage of the Unified Parkinson's Disease Rating Scale at 3 months was similar in both groups (robot: 71.4 ± 18 vs. frame: 72.6% ± 17, P = 0.82). There were no significant differences in the perioperative complications (robot: 4% vs. frame: 4.3%, P = 0.93) or in the adverse reactions related to brain stimulation and medical treatment (robot: 18% vs. frame: 25%, P = 0.53). There was a slight improvement in the anatomical-radiological accuracy of brain electrode implantation assisted by the robotic arm, measured using radial error (robot: 1.01 ± 0.5 mm vs. frame: 1.32 ± 0.6 mm, P = 0.03).
Both systems (robotic and stereotactic frame) exhibited similar initial clinical efficacies and safety profiles. The use of the robotic arm Neuromate slightly improved the anatomical-radiological accuracy in the placement of DBS electrodes for movement disorders compared with the stereotactic frame.
最近，机械臂已被应用于深部脑刺激（DBS）电极植入。本研究旨在确定与立体定向框架相比，机械臂Neuromate（雷尼绍）在运动障碍患者中脑电极植入的准确性、初始临床疗效和安全性。
本研究纳入两个回顾性队列：一个队列采用立体定向框架进行手术，另一个队列采用机械臂进行手术。本研究在巴塞罗那医院诊所开展。
共纳入77例患者，其中30例使用机器人进行手术，47例使用立体定向框架进行手术。两组患者术后3个月统一帕金森病评定量表的改善百分比相似（机器人组：71.4±18，框架组：72.6%±17，P = 0.82）。围手术期并发症（机器人组：4%，框架组：4.3%，P = 0.93）或与脑刺激及药物治疗相关的不良反应（机器人组：18%，框架组：25%，P = 0.53）方面无显著差异。使用机械臂辅助脑电极植入的解剖 - 放射学准确性略有提高，采用径向误差测量（机器人组：1.01±0.5mm，框架组：1.32±0.6mm，P = 0.03）。
两种系统（机器人系统和立体定向框架）均显示出相似的初始临床疗效和安全性。与立体定向框架相比，使用机械臂Neuromate在运动障碍DBS电极植入的解剖 - 放射学准确性方面略有提高。
