Comparison of novel machine vision spinal image guidance system with existing 3D fluoroscopy-based navigation system: a randomized prospective study

Abstract Objective: To describe a modification of the pterional approach (PT), the minipterional craniotomy (MPT), and compare the anatomic exposure provided by these two approaches. Methods: The anatomic exposure offered by the MPT and PT were compared in eight sides of cadaver heads using a computerized tracking system, a robotic microscope, and an image-guidance system. The area of surgical exposure, angular exposure, and anatomic limits of each craniotomy were evaluated. Three recently operated clinical cases (EGF) are also reported. Results: There were no statistical differences in the total area of surgical exposure between the two craniotomies (PT, 1524.7 ± 305 mm2; MPT, 1469.7 ± 380.3 mm2; P > 0.05) or among the ipsilateral, middle, and contralateral components of the area (P > 0.05). There were no differences in angular exposure along the longitudinal and transverse axis angles for the three selected targets, the bifurcations of internal carotid and middle cerebral arteries, and the anterior communicating artery (P > 0.05). Except for the distal portion of the operculoinsular compartment of the sylvian fissure, no significant differences in the limits of the surgical exposure through the PT and MPT were apparent on the image-guidance system. Conclusion: The MPT craniotomy provides comparable surgical exposure to that offered by the PT. The advantages of the MPT include reduction of tissue trauma and bony removal, a decrease in surgical time, and improved cosmetic outcomes.

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Development and Implementation of an Inexpensive, Easily Producible, Time Efficient External Ventricular Drain Simulator Using 3-Dimensional Printing and Image Registration

Operative Neurosurgery ◽

10.1093/ons/opy142 ◽

2018 ◽

Vol 16 (4) ◽

pp. 496-502 ◽

Cited By ~ 3

Author(s):

Hansen Bow ◽

Le He ◽

Muhammad Aanish Raees ◽

Sumit Pruthi ◽

Rohan Chitale

Keyword(s):

Image Guidance ◽

External Ventricular Drain ◽

Guidance System ◽

Foramen Of Monro ◽

3 Dimensional ◽

System A ◽

Frontal Horn ◽

Set Up ◽

The Right ◽

Dimensional Printing

Abstract BACKGROUND External ventricular drain (EVD) placement is one of the most commonly performed procedures in neurosurgery, frequently by the junior neurosurgery resident. Simulators for EVD placement are often costly, time-intensive to create, and complicated to set up. OBJECTIVE To describe creation of a simulator that is inexpensive, time-efficient, and simple to set up. METHODS This simulator involves printing a hollow head using a desktop 3-dimensional (3D) printer. This head is registered to a commercially available image-guidance system. A total of 11 participants volunteered for this simulation module. EVD placement was assessed at baseline, after verbal teaching, and after live 3D view instruction. RESULTS Accurate placement of an EVD on the right side at the foramen of Monro or the frontal horn of the lateral ventricle increased from 44% to 98% with training. Similarly, accurate placement on the left increased from 42% to 85% with training. CONCLUSION During participation in the simulation, accurate placement of EVDs increased significantly. All participants believed that they had a better understanding of ventricular anatomy and that this module would be useful as a teaching tool for neurosurgery interns.

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