Neurosurgical craniotomy localization using a virtual reality planning system versus intraoperative image–guided navigation

  • Axel T. Stadie
  • Ralf A. Kockro
  • Luis Serra
  • Gerrit Fischer
  • Eike Schwandt
  • Peter Grunert
  • Robert Reisch
Original Article

DOI: 10.1007/s11548-010-0529-1

Cite this article as:
Stadie, A.T., Kockro, R.A., Serra, L. et al. Int J CARS (2011) 6: 565. doi:10.1007/s11548-010-0529-1

Abstract

Purpose

Accurate craniotomy placement is essential for frameless neuronavigation in minimally invasive neurosurgery. A craniotomy using virtual reality (VR) can be as accurate as neuronavigation.

Methods

We prospectively enrolled 48 patients that underwent minimally invasive cranial procedures planned using VR, followed by neuronavigation. First, craniotomies were planned using VR derived measurements. Second, frameless neuronavigation was applied to define the craniotomy. The locations of these paired craniotomies were compared. A correctly placed craniotomy was defined as one that enabled the surgeon to totally remove the pathology without need to enlarge the craniotomy intraoperatively.

Results

Using VR, the size and the position of the craniotomy were measured correctly in 47 of 48 cases (98%). In 44 of 48 cases (92%), neuronavigation identified the craniotomy site correctly. In cases where neuronavigation failed, minimally invasive surgery was successfully completed using preoperative VR surgery planning. No statistically significant difference was found between craniotomy localization using VR surgery planning or standard frameless neuronavigation (p = 0.36).

Conclusion

The craniotomy for minimally invasive neurosurgical procedures can be identified accurately using VR surgery planning or neuronavigation. In cases of neuronavigation failure, VR surgery planning serves as an effective backup system to perform a minimally invasive operation.

Keywords

Craniotomy Surgical procedures Minimally invasive Neuronavigation Neurosurgical procedures Virtual reality Approach planning 

Copyright information

© CARS 2010

Authors and Affiliations

  • Axel T. Stadie
    • 1
  • Ralf A. Kockro
    • 2
  • Luis Serra
    • 3
  • Gerrit Fischer
    • 1
  • Eike Schwandt
    • 1
  • Peter Grunert
    • 1
  • Robert Reisch
    • 4
  1. 1.Neurochirurgische Klinik und PoliklinikUniversitätsmedizin MainzMainzGermany
  2. 2.Neurochirurgische KlinikUniversitätsspital ZürichZürichSwitzerland
  3. 3.National Neuroscience InstituteSingaporeSingapore
  4. 4.Zentrum für endoskopische und minimalinvasive NeurochirurgieZürichSwitzerland

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