Medical & Biological Engineering & Computing

, Volume 51, Issue 3, pp 331–341

Intraoperative forces and moments analysis on patient head clamp during awake brain surgery

Authors

    • Bioengineering DepartmentPolitecnico di Milano
  • Elena De Momi
    • Bioengineering DepartmentPolitecnico di Milano
    • Istituto di Tecnologie Industriali ed AutomazioneConsiglio Nazionale delle Ricerche
  • Lorenzo Conti
    • Bioengineering DepartmentPolitecnico di Milano
  • Emiliano Votta
    • Bioengineering DepartmentPolitecnico di Milano
  • Marco Riva
    • Neurochirurgia, Istituto Clinico Humanitas, IRCCSUniversità degli studi di Milano
  • Enrica Fava
    • Neurochirurgia, Istituto Clinico Humanitas, IRCCSUniversità degli studi di Milano
  • Lorenzo Bello
    • Neurochirurgia, Istituto Clinico Humanitas, IRCCSUniversità degli studi di Milano
  • Giancarlo Ferrigno
    • Bioengineering DepartmentPolitecnico di Milano
Original Article

DOI: 10.1007/s11517-012-1002-9

Cite this article as:
De Lorenzo, D., De Momi, E., Conti, L. et al. Med Biol Eng Comput (2013) 51: 331. doi:10.1007/s11517-012-1002-9

Abstract

In brain surgery procedures, such as deep brain stimulation, drug-resistant epilepsy and tumour surgery, the patient is intentionally awakened to map functional neural bases via electrophysiological assessment. This assessment can involve patient’s body movements; thus, increasing the mechanical load on the head-restraint systems used for keeping the skull still during the surgery. The loads exchanged between the head and the restraining device can potentially result into skin and bone damage. The aim of this work is to assess such loads for laying down the requirements of a surgical robotics system for dynamic head movements compensation by fast moving arms and by an active restraint able to damp such actions. A Mayfield® head clamp was tracked and instrumented with strain gages (SGs). SG locations were chosen according to finite element analyses. During an actual brain surgery, displacements and strains were measured and clustered according to events that generated them. Loads were inferred from strain data. The greatest force components were exerted vertically (median 5.5 N, maximum 151.87 N) with frequencies up to 1.5 Hz. Maximum measured displacement and velocity were 9 mm and 60 mm/s, with frequencies up to 2.8 Hz. The analysis of loads and displacements allowed to identify the surgery steps causing maximal loads on the head-restraint device.

Keywords

Awake brain surgeryForce sensorsIntraoperative force/moments measurementHead clampHead restMotion compensation

Copyright information

© International Federation for Medical and Biological Engineering 2012