Stereotactic Operations Using the O-Arm

Publisher： Karger

E-ISSN： 1423-0372|90|6|401-409

ISSN： 1011-6125

Source： Stereotactic and Functional Neurosurgery, Vol.90, Iss.6, 2012-10, pp. : 401-409

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

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Abstract

Background: In stereotactic operations, intraoperative imaging is crucial in several stages of the procedure. The aim was to utilize the O-arm intraoperatively for (1) planning the trajectories of stereotactic instruments, (2) calculating the coordinates of the targets, (3) identification of normal intracranial structures, (4) verification of the trajectories of the stereotactic instruments, and (5) visualization of intracranial hematoma. This is the first study using the O-arm for calculations of the target coordinates in frame-based stereotaxy. Methods: Utilization of the O-arm as a full-scale intraoperative imaging system in stereotactic surgery required a new concept. The concept consists of the O-arm as an intraoperative imaging system and the Leksell stereotactic system with a modified CT coordinate indicator box, with the idea to widen limited imaging volume. The accuracy and feasibility of the concept were studied. Results: The use of O-arm imaging was found to be clinically feasible, enabling the achievement of adequate technical accuracy for stereotactic operations with submillimeter errors in the calculation of target coordinates, and for multiple intraoperative control images when required. Conclusions: The O-arm could be used alone, with high accuracy, as an intraoperative imaging system for planning and controlling in stereotactic operations. In addition, it can be used to exclude serious complications, especially intracerebral hematoma.

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