Subscribe to RSS
DOI: 10.1055/s-2003-812535
Fluoroscopic Frameless Computer-Assisted Navigation for Transsphenoidal Surgery: A Clinical Assessment of Accuracy in Spatial Position and Trajectory
Publication History
Publication Date:
20 April 2004 (online)
Abstract
Objective: Fluoroscopic navigation technique in transsphenoidal surgery on the one hand provides multi-planar (antero-posterior and lateral views) navigation while on the other hand it does not need any preoperative preparation. To assess the clinical accuracy of the above technique in the transsphenoidal surgery, we performed this study.
Methods: 5 patients undergoing transsphenoidal surgery were assessed. Fluoroscopic images were compared with C-arm X-ray images for difference in spatial position and trajectory.
Results: 26 sets of data were collected for analysis. Mean pointer tip difference was 0.6 mm. The 95 % confidence interval was 1.3 mm. Mean trajectory difference was 1.2 degree. The 95 % confidence interval was 2.7 degree.
Conclusion: With a good clinical accuracy, fluoroscopic navigation offers a distinct advantage to replace the traditional fluoroscopic approach for transsphenoidal surgery for its low X-ray exposure and multi-planar (antero-posterior and lateral views) navigation.
Key words
Fluoroscopic navigation - transsphenoidal surgery - accuracy
References
- 1 Hardy J. Neuronavigation in pituitary surgery. Surg Neurol. 1999; 52 648-649
- 2 Hardy J. Frameless stereotaxy for transsphenoidal surgery. Neurosurgery. 2000; 46 1269-1270
- 3 Abe M, Udono H, Tabuchi K. et al . Transsphenoidal surgery assisted by navigation system. No Shinkei Geka. 2001; 29 31-38
- 4 Elias W J, Chadduck J B, Allen T D, Laws E R. Frameless stereotaxy for transphenoidal surgery. Neurosurgery. 1999; 45 271-277
- 5 Wong G K, Poon W S, Lam M K. The impact of an armless frameless neuronavigation system on routine brain tumour surgery: A prospective analysis of 51 cases. Minim Invas Neurosurg. 2001; 44 99-103
- 6 Jane J A, Thapar K, Tord D A, Laws E R. Fluoroscopic frameless stereotaxy for transsphenoidal surgery. Neurosurgery. 2001; 48 1302-1308
- 7 Hofstetter R, Slomczyki M, Sati M. et al . Fluoroscopy as an imaging means for computer-assisted surgical navigation. Comput Aided Surg. 1999; 4 65-76
- 8 Foley K T, Simon D A, Rampersaud Y R. Virtual fluoroscopy: Computer-assisted fluoroscopic navigation. Spine. 2001; 26 347-351
- 9 Nolte L P, Slomczykowski M A, Berlemann U. et al . A new approach to computer-aided spine surgery: fluoroscopy-based surgical navigation. Eur Spine J. 2000; 9 (Suppl 1) S78-S88
- 10 Youkilis A S, Quint D J, McGillicuddy J E. et al . Stereotactic navigation for placement of pedicle screws in the thoracic spine. Neurosurgery. 2001; 48 771-779
- 11 Bland J M, Altman D G. Statistical methods for assessing agreement two methods of clinical measurement. Lancet. 1986; I (8476) 307-310
- 12 Hollis S. Analysis of method comparison studies. Ann Clin Biochem. 1996; 33 1-4
W. S. Poon,FRCS
Division of Neurosurgery · Department of Surgery · Prince of Wales Hospital
Shatin
New Territories
Hong Kong SAR
China
Phone: + 852-2632-2624
Fax: + 852-2637-7974
Email: wpoon @surgery.cuhk.edu.hk