Method for Placing Deep-Brain Stimulators

摘要

A new system is evaluated for implanting deep-brain stimulators into the brain. The system relies on the custom construction of a rigid, one-piece mounting platform for each patient. During surgery the platform is attached rigidly to posts that are implanted into the patient's skull and extend outward through the scalp. The platform then acts as a miniature stereotactic frame that provides guidance for a catheter as it is advanced through a burr hole to the target. The target is selected on a pre-operative CT image. That image is acquired after the posts have been implanted and outfitted with fiducial markers. The positions of the markers and the target are used to design the platform. After initial implantation, the electrode's position is adjusted interoperatively on the basis of physical effects of stimulation, but the accuracy of the initial placement is determined entirely by the registration of the image to the physical anatomy through the shape of the platform and its placement on the posts. In this work, we test that accuracy by comparing the position of the electrode in post-operative patient images with the positions in the pre-operative images as determined by a rigid registration based on the fiducial markers.