Author(s): Hussain M.; Sunderland G.; Franceschini P.; Tambirajoo K.; Byrne P.; Farah J.; Eldridge P.

Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 1); p. 101-102

Publication Date: 2018

Publication Type(s): Conference Abstract

Abstract:Objectives: Multiple stereotactic methods for insertion of deep brain electrodes are available. We have experience in using the Nexframe and CRW frame. In this study we will analysis and accuracy of the frames and compare the two systems. Design: Prospectively collected data over 10 years. Subjects: Deep Brain Stimulation. Methods: Data analysed using SPSS. Results: In total 456 deep brain stimulator electrodes were inserted, 150 using a CRW frame and 306 using Nexframe. Planning was carried out using Framelink (Medtronic) software and post op imaging was fused with the pre-op plan, this allowed us to record the actual coordinates of the implanted electrode (most distal contact as actual target). Comparing planned target vs actual target allowed analysis of the accuracy. The average deviation from the target in each coordinate was <1mm for both systems used. We analysed the distance from target for each electrode in 3 dimensions, and found the mean error to be 2.58mm (SE 0.10) and 2.70mm (SE 0.16) for the Nexframe and CRW respectively, with no significant difference in accuracy between the two systems (t-test p< 0.05). Conclusions: The accuracy of both systems used are comparable to published data. Therefore, the selection of the system used should be based on clinical need. The frame used is only one part a complex procedure, just as much focus and attention needs to be given to other steps in the process. Having a standardised set procedure allows the surgeon to minimise error in each part of the operation and therefore improve overall accuracy.

Database: EMBASE

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