Articles: neuronavigation.
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Expert Rev Med Devices · Jan 2008
ReviewRole of pre- and intraoperative imaging and neuronavigation in neurosurgery.
Advances in neuroimaging acquisition, computing and image processing have enabled neurosurgeons to use radiological imaging to guide both preoperative planning and intraoperative guidance. In preoperative planning, imaging may be used to evaluate surgical risks, choose the best method of intervention and select the safest surgical approach. ⋯ In the following review, we briefly examine the history of neuroradiology for neurosurgery, neuronavigation and intraoperative imaging and trace their advances to current systems in use. We will also highlight new experimental applications of neuroimaging that are currently being refined.
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Transaqueductal navigation of the fourth ventricle has long been considered dangerous and of no clinical relevance. After the refinement of the endoscopic technique and supported by the extensive experience gained at the authors' institution since 1994, endoscopic exploration of the fourth ventricle has been performed by the same surgeon in 54 patients. In all cases reviewed, endoscopic navigation of the fourth ventricle was successfully performed with no related neurological deficit. This preliminary experience shows the feasibility of transaqueductal navigation of the fourth ventricle, which is made possible by the use of small, flexible endoscopes in expert hands.
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Review Case Reports
[Role of image guided surgery with navigation system for the skull base lesion].
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With the rapid evolution of technologic advances in neurosurgery, it is no surprise that the use of MR imaging to guide the performance of safe and effective surgical procedures is at the forefront of development. This article highlights the current capabilities of intraoperative MR-guided surgery for a variety of neurosurgical procedures and traces the evolution of the field to its present level of technical sophistication. The costs of intraoperative MR imaging and its future directions are discussed.
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Computer aided and computer navigated operative techniques have been used for the first time in neurosurgery and surgery of the spine. For computer aided surgery of the spine there are currently two different methods: CT-based and C-arm based techniques. The advantage of the CT-based technique is its accuracy especially in difficult anatomical regions like the cervical and upper thoracic spine, and the possibility of preoperative planning. ⋯ Generally, all methods enhance the precision of pedicle screw insertion. Clinical as well as experimental studies show an exact pedicle screw position using the computer navigated techniques in over 90% of cases. C-arm based navigational techniques are being constantly improved and the future will be CT-like images with instant intraoperative availability.