Articles: neuronavigation.
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Pedicle screw fixation is the most preferred method of stabilizing unstable spinal fractures. Pedicle screw placement may be difficult in presence of fractured posterior elements, deformed spine, gross instability and spinal pathology. Challenging spine-fracture fixation is defined as the presence of one or more of the following: 1) obscured topographical landmarks as in ankylosing spondylitis, 2) fractures in occipitocervical or cervicothoracic regions and 3) preexisting altered spinal alignment. We report a series of pedicle screw insertion with guidance of navigation in difficult fixation problems.. ⋯ Intraoperative Iso-C 3D C-arm based navigation is a useful adjunct while stabilizing challenging spinal trauma, rendering feasibility, accuracy and safety of pedicle screw placement even in difficult situations.
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Minim Invas Neurosur · Oct 2007
Neuronavigation and resection of lesions located in eloquent brain areas under local anesthesia and neuropsychological-neurophysiological monitoring.
The aim of this study was to determine the safety and maximal extension of tumor resection achievable with a combination of awake craniotomy under local anesthesia, neuronavigation, and continuous neuropsychological and neurophysiological monitoring in patients with lesions within the eloquent brain. ⋯ The combination of neuronavigation with cortical stimulation and repetitive neurological and language examinations allows a more radical resection of tumors in eloquent brain areas, otherwise considered as inoperable.
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Journal of neurosurgery · Sep 2007
Accuracy of ventriculostomy catheter placement using a head- and hand-tracked high-resolution virtual reality simulator with haptic feedback.
The purpose of this study was to evaluate the accuracy of ventriculostomy catheter placement on a head- and hand-tracked high-resolution and high-performance virtual reality and haptic technology workstation. ⋯ The accuracy of virtual ventriculostomy catheter placement achieved by participants using the simulator is comparable to the accuracy reported in a recent retrospective evaluation of free-hand ventriculostomy placements in which the mean distance from the catheter tip to the Monro foramen was 16 mm (+/- 9.6 mm).
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Minim Invas Neurosur · Aug 2007
Multiple brain tumor nodule resections under direct visualization of a neuronavigated endoscope.
With neuronavigation-assistance, endoscopic neurosurgery has a variety of advantages for brain tumor resection. However, intraoperative neuronavigation has to be operated by frequently alternating a neuronavigation wand and moving the microscope back-and-forth on the surgical field while the microscope is being used for surgery, except when using stereo overlays in the operating microscope aligned to the operative scene. In our practice, our surgical endoscope was used as a sole optical device and was also calibrated as a virtual wand targeting to tumor nodules while the operation was being performed under its simultaneous visualization. This paper gives a brief description and technical report of applications of image-guided endoscopy in two cases with multiple tumor nodules. ⋯ The neuronavigated endoscope coordinates of the tip of endoscope, and the trajectory of targets, provide both 3D orientation and direct endoscopic visualization simultaneously, and present with the unique feature for solely endoscopic minimally invasive procedures, especially for multiple intracranial lesions.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2007
Clinical TrialClinical significance of preoperative fibre-tracking to preserve the affected pyramidal tracts during resection of brain tumours in patients with preoperative motor weakness.
To clarify the clinical usefulness of preoperative fibre-tracking in affected pyramidal tracts for intraoperative monitoring during the removal of brain tumours from patients with motor weakness. ⋯ Preoperative fibre-tracking could predict the clinical usefulness of intraoperative electrical stimulation of the motor cortex and subcortical fibres (ie, pyramidal tracts) to preserve affected motor function during removal of brain tumours. In patients for whom fibre-tracking failed preoperatively, awake surgery is more appropriate to evaluate and preserve moderately impaired muscle strength.