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History and Overview of Neural Engineering
Published in Joseph D. Bronzino, Donald R. Peterson, Biomedical Engineering Fundamentals, 2019
Daniel J. DiLorenzo and Robert E. Gross
By the 1970s, when Parkinson’s disease was mostly being treated pharmacologically, the usual indication for stereotactic surgery in movement disorders was tremor and hyperkinesias (e.g., in dystonia), and the preferred operation was thalamotomy of the ventral intermediate (Vim) nucleus. It had long been appreciated that acute high frequency, but not low-frequency electrical stimulation of Vim led to immediate tremor arrest, which was used as a nal check prior to radiofrequency ablation [121,122]. e rst chronic stimulator implantations directed at movement disorders per se were by Mundinger in 1975 [123]. Brice and McClellan [124] implanted DBS leads in the subthalamic region (a common site for subthalamotomy at the time) in three patients for severe intention tremor resulting from multiple sclerosis. e latter paper is of special interest in that it anticipates by decades the idea of a contingent, on-demand system. Andy [125] implanted nine patients with stimulating electrodes in the thalamus, but concluded that the likely target was CM/Pf.
Medical Image Registration and Fusion Techniques: A Review
Published in Alexander D. Poularikas, Stergios Stergiopoulos, Advanced Signal Processing, 2017
The use of external skin markers is a well-documented and relatively simple approach. They are placed physically on the patient prior to the acquisition of the image. The use of four skin markers for registering CT-MR data using 3-D global rigid transformation was reported in Clarysse et al. [8]. A similar application on CT images for stereotactic surgery was described in Schad et al. [46]. A combination of skin markers with affine transformation appears in Hawks et al. [47], considering SPECT and MR images whereas SPECT and PET images were registered with CT images using four skin markers and a least square fit method in Arun et al. [48].
Image-Guided Surgery
Published in John G Webster, Minimally Invasive Medical Technology, 2016
Stereotactic systems have been used since the turn of the century for anatomical studies and surgical procedures of the brain. The term is derived from the Greek root stereo (meaning three-dimensional) and the Latin root tactic (meaning to touch). It refers to the localization of structures in the body (Lemieux et al 1993). Stereotactic systems establish a coordinate system that can map pre- or interoperative images (image space), surgical instruments and the surgical field (physical space) all in one coordinate system to accurately guide surgical procedures. Methods available to perform the registration of image space and physical space include (1) atlas methods, (2) curve and surface methods, and (3) point methods. The main applications of stereotactic imaging are head surgeries (including neurosurgery, sinus surgery, oral surgery and maxillofacial surgery), hip surgeries and spinal surgeries. High spatial fidelity for the registration is imperative for these procedures and two categories for proper registration exist: frame-based and frameless stereotactic surgery. Frame-based stereotactic systems require an external frame that is attached to the patient prior to image acquisition. The methods discussed below differ in their accuracy, the physical principles used to derive positions in the surgical field, and their intrinsic advantages and disadvantages.
Computer-assisted surgery in medical and dental applications
Published in Expert Review of Medical Devices, 2021
Yen-Wei Chen, Brian W. Hanak, Tzu-Chian Yang, Taylor A. Wilson, Jenovie M. Hsia, Hollie E. Walsh, Huai-Che Shih, Kanako J. Nagatomo
Neuronavigation arose through a combination of stereotaxy, neuroimaging, and computer technology [6,7]. Stereotaxy is an approach to localizing and targeting a specific point within a defined space using a three-dimensional coordinate system. Thus, regarding the brain as a geometric volume, stereotactic surgery utilizes a coordinate system to precisely and accurately target any structure within the brain [8]. In the early 1900s, stereotactic neurosurgery began by using a three-dimensional Cartesian coordinate system defined by a rigid frame affixed to the patient’s head to target specific anatomical regions in the brain. These early frame-based stereotactic systems were used to localize deep brain structures based on external skull landmarks using relationships defined by normalized cadaveric dissection studies, giving rise to the field of ‘craniometry’ [9]. Not surprisingly, however, these early stereotactic systems, of which there were several, all suffered from inaccuracies generated by the variability of brain structures’ correlation with skull landmarks.
Device profile of the XVision-spine (XVS) augmented-reality surgical navigation system: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2021
Christopher F. Dibble, Camilo A. Molina
XVS was FDA-approved class II on 16 December 2019 ‘intended as an aid for precisely locating anatomical structures in either open or percutaneous spine procedures.’ Use is indicated for ‘any medical condition in which the use of stereotactic surgery may be appropriate, and where reference to a rigid anatomical structure, such as the spine, can be identified relative to CT imagery of the anatomy,’ including posterior pedicle screw placement in the thoracolumbar region. This was based upon judgment from the FDA that the XVS system is substantially equivalent to Metronic’s StealthStation S8 Spine Software, with minor differences in indications and similar performance data. This is the most commonly used neuronavigation system at present. XVS is currently approved for use in the United States and CE mark in Europe is pending.
The Neurostructure of Morality and the Hubris of Memory Manipulation
Published in The New Bioethics, 2018
DBS is a surgical procedure in which an electrode is implanted in one or more deep brain areas (such as the basal ganglia) and connected to a device that generates high-frequency electrical stimulation (130–180 hertz) (Henderson et al. 2010, pp. 1–7). The impulse-generating device is subsequently implanted subcutaneously, typically within chest-range. In stereotactic surgery, the electrodes are implanted in the brain after drilling four holes into the cranium. The patients are often kept conscious during the procedure so as to respond adequately to neurological testing. This is done to ensure that the various electrodes are located properly and produce the desired effect upon triggering (Unterrainer and Oduncu 2015, pp. 475–85). First developed in the 1990s, this invasive method traditionally aimed to ameliorate symptoms associated with movement disorders, especially in advanced Parkinson’s disease. However, DBS is now more frequently employed for diverse experimental applications such as psychiatric disorders, including depression, weight reduction, cluster headaches, epilepsy, substance addiction, post-traumatic stress, obsessive-compulsive disorder, intractable pain, and minimally conscious states. Today, over 30,000 implants have been reported worldwide, and most have gleaned impressive benefits and quality of life improvements ((Unterrainer and Oduncu 2015, p. 475).