title: Customized, miniature rapid-prototype stereotactic frames for use in deep brain stimulator surgery: initial clinical methodology and experience from 263 patients from 2002 to 2008.
abstract: BACKGROUND
  The microTargeting™ platform (MTP) stereotaxy system (FHC Inc., Bowdoin, Me., USA) was FDA approved in 2001 utilizing rapid-prototyping technology to create custom platforms for human stereotaxy procedures. It has also been called the STarFix (surgical targeting fixture) system since it is based on the concept of a patient- and procedure-specific surgical fixture. This is an alternative stereotactic method by which planned trajectories are incorporated into custom-built, miniature stereotactic platforms mounted onto bone fiducial markers. Our goal is to report the clinical experience with this system over a 6-year period.
  
  
  METHODS
  We present the largest reported series of patients who underwent deep brain stimulation (DBS) implantations using customized rapidly prototyped stereotactic frames (MTP). Clinical experience and technical features for the use of this stereotactic system are described. Final lead location analysis using postoperative CT was performed to measure the clinical accuracy of the stereotactic system.
  
  
  RESULTS
  Our series included 263 patients who underwent 284 DBS implantation surgeries at one institution over a 6-year period. The clinical targeting error without accounting for brain shift in this series was found to be 1.99 mm (SD 0.9). Operating room time was reduced through earlier incision time by 2 h per case.
  
  
  CONCLUSIONS
  Customized, miniature stereotactic frames, namely STarFix platforms, are an acceptable and efficient alternative method for DBS implantation. Its clinical accuracy and outcome are comparable to those associated with traditional stereotactic frame systems.
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, TN 37232, USA. peter.konrad@vanderbilt.edu
authors.forename: Peter E
authors.initials: PE
authors.lastname: Konrad
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Neimat
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.forename: Chris C
authors.initials: CC
authors.lastname: Kao
authors.forename: Michael S
authors.initials: MS
authors.lastname: Remple
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: D'Haese
authors.forename: Benoit M
authors.initials: BM
authors.lastname: Dawant
mesh_terms: D046690:Deep Brain Stimulation / Q000295:instrumentation* / Q000379:methods; D057918:Fiducial Markers; D006801:Humans; D058542:Implantable Neurostimulators; D009069:Movement Disorders / Q000601:surgery; D016634:Radiosurgery / Q000295:instrumentation* / Q000379:methods; D013523:Surgical Equipment; D016896:Treatment Outcome