title: Accuracy of stereotactic electrode placement in deep brain stimulation by intraoperative computed tomography.
abstract: The purpose of this study was to evaluate the accuracy of stereotactic electrode placement in patients undergoing deep brain stimulation by using pre- and postoperative computed tomography (CT). Twenty-three patients with movement disorders (Parkinson's disease (n=7), tremor (n=9), dystonia (n=7)) treated with bilateral deep brain stimulation (DBS) (overall 46 target points) were investigated. The target point of the electrode was planned stereotactically in combination with a preoperative stereotactic helical computed tomography (CT). A postoperative CT, which was carried out still in the operating room while the patient had the stereotactic frame on the head, was performed in order to control the position of the electrodes in relation to the previously planned target point. The position of the four electrode contacts was measured according to the Talairach space (AC-PC line) and compared with the coordinates of the planned target point. The mean spatial distance of planned target perpendicular to the electrode was 1.32+/-0.75mm. These results show the high accuracy of stereotactic implantation of DBS electrodes assisted by pre- and postoperative image fusion with computed tomography (CT).
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. thomas.fiegele@i-med.ac.at
authors.forename: Thomas
authors.initials: T
authors.lastname: Fiegele
authors.forename: Gudrun
authors.initials: G
authors.lastname: Feuchtner
authors.forename: Florian
authors.initials: F
authors.lastname: Sohm
authors.forename: Richard
authors.initials: R
authors.lastname: Bauer
authors.forename: Jürgen Volker
authors.initials: JV
authors.lastname: Anton
authors.forename: Thaddäus
authors.initials: T
authors.lastname: Gotwald
authors.forename: Klaus
authors.initials: K
authors.lastname: Twerdy
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Eisner
mesh_terms: D046690:Deep Brain Stimulation / Q000379:methods; D004566:Electrodes; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009069:Movement Disorders / Q000145:classification / Q000000981:diagnostic imaging* / Q000628:therapy; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed / Q000379:methods*