Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up.
Identifieur interne : 001664 ( Ncbi/Merge ); précédent : 001663; suivant : 001665Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up.
Auteurs : Stephan Chabardes [France] ; Stephanie Isnard ; Anna Castrioto ; Manuella Oddoux ; Valerie Fraix ; Lore Carlucci ; Jean François Payen ; Alexandre Krainik ; Paul Krack ; Paul Larson ; Jean François Le BasSource :
- Acta neurochirurgica [ 0942-0940 ] ; 2015.
English descriptors
- KwdEn :
- MESH :
- methods : Deep Brain Stimulation, Magnetic Resonance Imaging, Neuronavigation.
- physiology : Subthalamic Nucleus.
- surgery : Parkinson Disease, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Aged, Female, Humans, Male, Treatment Outcome.
Abstract
Improvement of surgical accuracy during DBS-lead implantation has been described recently, leading to "frameless" or "MRI-verified" techniques. However, combining a high-quality definition of the STN using intraoperative 1.5 MRI with the possibility to reduce errors due to co-registration and to monitor lead progression during surgical insertion while checking the absence of surgical complication is an appealing method. We report here surgical methodology, safety, application accuracy, and clinical benefit of STN-lead implantation under MRI guidance.
DOI: 10.1007/s00701-015-2361-4
PubMed: 25788414
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pubmed:25788414Le document en format XML
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<front><div type="abstract" xml:lang="en">Improvement of surgical accuracy during DBS-lead implantation has been described recently, leading to "frameless" or "MRI-verified" techniques. However, combining a high-quality definition of the STN using intraoperative 1.5 MRI with the possibility to reduce errors due to co-registration and to monitor lead progression during surgical insertion while checking the absence of surgical complication is an appealing method. We report here surgical methodology, safety, application accuracy, and clinical benefit of STN-lead implantation under MRI guidance.</div>
</front>
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<ArticleTitle>Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up.</ArticleTitle>
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<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Improvement of surgical accuracy during DBS-lead implantation has been described recently, leading to "frameless" or "MRI-verified" techniques. However, combining a high-quality definition of the STN using intraoperative 1.5 MRI with the possibility to reduce errors due to co-registration and to monitor lead progression during surgical insertion while checking the absence of surgical complication is an appealing method. We report here surgical methodology, safety, application accuracy, and clinical benefit of STN-lead implantation under MRI guidance.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Two patients with a severe PD state were treated by bilateral STN-DBS. Leads were implanted under general anesthesia using intraoperative MRI guidance (ClearPoint system). Lead implantation accuracy was measured on T1 axial images at the level of the target. Clinical improvement was measured on the pre- and post-UPDRS 3 scale at 1-year follow-up.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Surgery was safe and uneventful in both cases. Radial error was 0.36 (right) and 0.86 mm (left) in case 1, and 0.41 (right) and 0.14 mm (left) in case 2. No edema or hemorrhage were noticed.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Intraoperative MRI guidance allows DBS lead implantation with high accuracy and with great clinical efficacy. A larger cohort of patients is needed to confirm these initial results.</AbstractText>
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