July 13, 2020

Neuronavigation in Neurosurgery, Is it necessary? Why?

Neuro-navigation, also called as frameless stereotactic surgery is the technique which involves performance of real-time intraoperative guidance during spinal or brain injuries. This increases safety and accuracy during neurosurgery. Neuro-navigation systems help to guide the surgeon to the surgical targets without the need for external frames. These systems are used majorly in brain surgeries which helps to limit the size of skull opening or craniotomy and remove brain lesions such as tumors or other tissue masses.

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Localization and delineation of extent of lesions are critical for safe maximal resection of brain and spinal cord tumors. Neuronavigation systems have been developed for image-guided neurosurgery to aid in the accurate resection of brain tumors. Basic principles of navigated surgery are to see the tip of a pointer in an image space. A relationship between the device space and the image space has to be established. This operation is called registration or calibration of the navigation device. Basically, a transformation matrix (T) has to be calculated to map the coordinates of any point between the image and the device spaces. The aim of transformation matrix is to create a linkage between digital image data and anatomical structure, and therefore, to provide increasing 3-D orientation. Today's navigation systems provide approximately 2mm accuracy.

The study reviews the merits and demerits of the pointer and microscope based navigational systems and also highlights the role of functional brain mapping and intraoperative MRI, when integrated with neuronavigation, in the surgical decision-making to offer the chances of more radical resections with minimal morbidity.

Source: The Insight Partners