title: Use of the NeuroMate stereotactic robot in a frameless mode for movement disorder surgery.
abstract: OBJECTIVE
  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.
authors.affiliation: Walton Centre for Neurology and Neurosurgery, Liverpool, UK. tv.varma@thewaltoncentre.nhs.uk
authors.forename: T R K
authors.initials: TR
authors.lastname: Varma
authors.forename: P R
authors.initials: PR
authors.lastname: Eldridge
authors.forename: A
authors.initials: A
authors.lastname: Forster
authors.forename: S
authors.initials: S
authors.lastname: Fox
authors.forename: N
authors.initials: N
authors.lastname: Fletcher
authors.forename: M
authors.initials: M
authors.lastname: Steiger
authors.forename: P
authors.initials: P
authors.lastname: Littlechild
authors.forename: P
authors.initials: P
authors.lastname: Byrne
authors.forename: A
authors.initials: A
authors.lastname: Sinnott
authors.forename: K
authors.initials: K
authors.lastname: Tyler
authors.forename: S
authors.initials: S
authors.lastname: Flintham
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D009069:Movement Disorders / Q000601:surgery*; D019635:Neurosurgical Procedures; D012371:Robotics; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted