title: Intraoperative 3D imaging control during subthalamic Deep Brain Stimulation procedures using O-arm® technology: Experience in 15 patients.
abstract: OBJECTIVE
  O-arm(®) now gives us the opportunity not only to perform 2D but also 3D scans during deep brain stimulation (DBS) procedures. We present our experience with the intraoperative use of this device. Our objective was to measure the geometrical accuracy of electrode placement during surgical procedures driven under O-arm(®) control.
  
  
  METHODS
  Fifteen patients underwent STN-DBS. For the first 4 patients, 3D scans were performed at the end of the procedure. We calculated the accuracy of electrode positioning, i.e. the distance between final electrode positioning and the planned trajectory. For the next 11 patients, who underwent both intraoperative and final 3D scan, we also calculated the accuracy of the microelectrode positioning.
  
  
  RESULTS
  Average stimulation-induced improvement of UPDRS-III score was 52.5±15%. For the first 4 patients, the mean electrode positioning accuracy was 1.46±0.56mm. For the 11 patients who underwent intraoperative 3D scan, the mean microelectrodes positioning accuracy was 1.59±1.1mm. Aberrant positioning was detected in two cases, and was analyzed by fusing 3D scan with preoperative MR images. The definite electrodes positioning accuracy was 1.05±0.54mm.
  
  
  CONCLUSIONS
  Intraoperative 3D scan is feasible, and can help us detect and correct early aberrant trajectories.
authors.affiliation: Service de neurochirurgie, CHU de Limoges, 87000 Limoges, France; Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France. Electronic address: francois.caire@chu-limoges.fr.
authors.forename: F
authors.initials: F
authors.lastname: Caire
authors.affiliation: Unité d'électrophysiologie et exploration fonctionnelle du système nerveux, CHU de Bordeaux, 33000 Bordeaux, France; Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France.
authors.forename: D
authors.initials: D
authors.lastname: Guehl
authors.affiliation: Unité d'électrophysiologie et exploration fonctionnelle du système nerveux, CHU de Bordeaux, 33000 Bordeaux, France; Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Burbaud
authors.affiliation: Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Benazzouz
authors.affiliation: Service de neurochirurgie A, CHU de Bordeaux, 33000 Bordeaux, France; Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France.
authors.forename: E
authors.initials: E
authors.lastname: Cuny
mesh_terms: D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000295:instrumentation; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010300:Parkinson Disease / Q000628:therapy*; D025321:Surgery, Computer-Assisted
keywords: CT scan; Deep brain stimulation; Functional neurosurgery; Imagerie préopératoire; Intraoperative imaging; Neuronavigation; Scanner; Stimulation cérébrale profonde