Factors Affecting Stereotactic Accuracy in Image-Guided Deep Brain Stimulator Electrode Placement

Background/Aims: Intraoperative imaging allows near-real-time assessment of stereotactic accuracy during implantation of deep brain stimulation (DBS) electrodes. Such technology can be used to examine factors impacting stereotactic error.Methods: Intraoperative CT imaging was reviewed in patients undergoing DBS placement at Oregon Health and Sciences University. Coordinates of the target electrode were compared to the operative plan to characterize the magnitude and direction of stereotactic error with respect to side of implantation, target, and electrode approach angles.Results: One hundred sixty-nine leads in 94 patients were examined. Targets were GPi (n = 86), STN (n = 31), and Vim (n = 52). The average Euclidean error was 1.63 mm (SD 0.87). The error magnitude was higher for Vim (1.95 mm) than for GPi (1.44 mm), while STN (1.65 mm) did not differ from either Vim or GPi (ANOVA:F = 6.15,p = 0.003). Electrodes targeting Vim and STN were significantly more likely to deviate medially compared to those targeting GPi (ANOVA:F = 9.13,p
Source: Stereotactic and Functional Neurosurgery - Category: Neurosurgery Source Type: research