Desgeorges M, Derosier C, Hor F, Cordoliani Y S, Traina M, de Soultrait F, Bernard C, Khadiri M, Debono B
Service de neurochirurgie, H.I.A. Val-de-Grâce, Paris.
J Neuroradiol. 1997 Aug;24(2):108-15.
In 1988, the neurosurgeons and neuroradiologists at the Val-de-Grâce hospital decided to create a stereotaxis site using advanced medical imaging date (CT-scan or MRI).
Two MRI machines and on CT unit were linked to a network (ETHERNET) available for radiologists in 1989. Neurosurgeons adapted stereotaxis sites using Leksell, Fisher and CRW software for MRI. A data processing program recognizing these sites was developed for stereotaxic biopsies based on MRI data. The network was extended in 1992 to the radiotherapy unit for multiple beam stereotaxic irradiations. Finally from 1994, when a computer-guided microscope (Zeiss MKM) was installed, nearly all neurosurgical procedures were conducted under stereotaxic conditions.
Since 1989, approximately 900 computer-guided stereotaxic biopsies have been performed with precision in the millimeter range. Since 1994, the Zeiss MKM microscope has been used for 120 computer-guided procedures with the frameless stereotaxic technique guided from landmarks on the outer cranium or attached to the scalp. Mean precision obtained with landmarks was 1.2 mm and 2.8 mm with scalp markers.
These techniques of computer-assisted neurosurgery based on advanced medical imaging techniques has been revolutionary for surgical approach to intracranial and intracerebral diseases. Smaller assess routes and precise pathways allow an approach to formerly inoperable lesions with minimal risk.
1988年，瓦尔德格拉斯医院的神经外科医生和神经放射科医生决定利用先进的医学成像数据（CT扫描或MRI）创建一个立体定向手术点。
1989年，两台MRI机器和一台CT设备连接到一个可供放射科医生使用的网络（以太网）。神经外科医生采用Leksell、Fisher和CRW软件对MRI的立体定向手术点进行调整。开发了一个基于MRI数据识别这些手术点的数据处理程序，用于立体定向活检。1992年，该网络扩展到放射治疗科，用于多束立体定向照射。最后，从1994年安装了计算机引导显微镜（蔡司MKM）开始，几乎所有的神经外科手术都在立体定向条件下进行。
自1989年以来，已精确进行了约900例计算机引导的立体定向活检，精度在毫米范围内。自1994年以来，蔡司MKM显微镜已用于120例计算机引导手术，采用从颅骨外表面或附着于头皮的标志物引导的无框架立体定向技术。使用标志物获得的平均精度为1.2毫米，使用头皮标记物时为2.8毫米。
这些基于先进医学成像技术的计算机辅助神经外科技术，对于颅内和脑内疾病的手术入路具有革命性意义。更小的评估路径和精确的手术路径，使得能够以最小的风险接近以前无法手术的病变。
