Use of the NeuroMate Stereotactic Robot in a Frameless Mode for Movement Disorder SurgeryVarma T.R.K. · Eldridge P.R. · Forster A. · Fox S. · Fletcher N. · Steiger M. · Littlechild P. · Byrne P. · Sinnott A. · Tyler K. · Flintham S.
Walton Centre for Neurology and Neurosurgery, Liverpool, UK
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Background/Aims: To evaluate the use of the NeuroMate stereotactic robot with a novel ultrasound registration system for movement disorder surgery (MDS). Methods: Using the robot in a frameless mode, 51 patients underwent MDS. Surgical planning was carried out using MRI data obtained more than 24 h before surgery. Results: 37 out of 50 targets in the subthalamic nucleus were satisfactorily identified with a single microelectrode trajectory and the final electrode positions were at a mean distance of 1.7 mm from the calculated target. There was a significant improvement in motor scores of the Unified Parkinson’s Disease Rating Scale III (off medication) at 6 (43%) and 18 months (51.7%) compared to pre-operative scores (p < 0.05). Conclusions: The frameless robot using only MRI data can be used for MDS. The temporal separation of imaging from the surgical procedure provides additional time for detailed image analysis and planning.
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