Evaluation of the accuracy, efficiency and safety of Stereoelectroencephalography with robotic assisted electrode placement compared to traditional frame based stereotaxy

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-06-18 DOI:10.1016/j.jocn.2025.111403

Charles T. Fish , Thanomporn Wittayacharoenpong , Christopher Donaldson , Joshua Laing , Andrew Neal , Hugh D. Simpson , Martin Hunn , Terence J. O’Brien , Matthew Gutman

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引用次数: 0

Abstract

Background

Stereoelectroencephalography (SEEG) has been used to localise the epileptogenic zone in focal epilepsy for several decades. Our centre’s current method of implantation with a CRW Precision Arc system will soon be no longer supported in our region, necessitating alternative devices in SEEG procedures. In this study we compared accuracy, efficiency and safety of the CRW frame with the Autoguide robotic system.

Methods

A retrospective review of a prospectively maintained database was performed of all patients in a single Australian institution who underwent SEEG between August 2019 and July 2024. Pre- and post-operative stereotactic image-based analysis was performed, with target accuracy and error measurements, operation time logs, and inpatient notes reviewed.

Results

50 patients with a total of 629 electrodes were identified who had undergone SEEG electrode implantation with the CRW frame and 8 patients with a total of 119 electrodes with the assistance of the Medtronic Autoguide robot. The electrode target point error was significantly lower in the CRW group (1.85 mm [1.23–2.58]) compared to the Autoguide assisted group (2.97 mm [1.81––4.22], p = 0.01). The difference was also significant in the individual parameters of depth error (0.57 vs.1.33 mm, p = 0.01) and the radial error (1.56 vs. 2.25 mm, p = 0.01). Bone entry point error was lower in the CRW group (1.04 vs. 2.32 mm, p < 000.1). However, the Autoguide assisted cases demonstrated a significant reduction in pre-implantation time (104.9 Vs. 129.0 min, p = 0.01) and time per electrode (13.9 vs 17.3 min, p = 0.005) compared to the CRW frame. Neither group recorded any significant adverse events nor required re-implantation due to electrode inaccuracy.

Conclusions

Our experience demonstrates that the Medtronic Autoguide robot can safely be used for SEEG electrode implantation, and has improved the pre-implantation and implantation time per electrode for SEEG cases. However, accuracy in our initial cohort was reduced compared to the CRW frame.

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与传统的基于框架的立体定位相比，机器人辅助电极放置立体脑电图的准确性、效率和安全性评估

几十年来，立体脑电图（SEEG）一直被用于定位局灶性癫痫的致痫区。本中心目前使用的CRW精密电弧系统植入方法将很快在本地区不再支持，因此需要在SEEG程序中使用替代设备。在这项研究中，我们比较了CRW框架与Autoguide机器人系统的精度、效率和安全性。方法对2019年8月至2024年7月在澳大利亚一家机构接受SEEG治疗的所有患者的前瞻性数据库进行回顾性分析。进行术前和术后基于立体定向图像的分析，包括目标精度和误差测量、手术时间记录和住院记录。结果50例患者共629个电极采用CRW框架植入SEEG电极，8例患者共119个电极采用Medtronic Autoguide机器人辅助植入。CRW组电极靶点误差（1.85 mm[1.23-2.58]）明显低于Autoguide辅助组（2.97 mm[1.81—4.22],p = 0.01）。深度误差（0.57 vs.1.33 mm, p = 0.01）和径向误差（1.56 vs. 2.25 mm, p = 0.01）的单项参数差异也显著。CRW组入骨点误差较低(1.04 vs 2.32 mm, p <；000.1)。然而，与CRW框架相比，Autoguide辅助的病例显示植入前时间（104.9 vs 129.0 min, p = 0.01）和每个电极时间（13.9 vs 17.3 min, p = 0.005）显著减少。两组均未记录任何显著不良事件，也未因电极不准确而需要重新植入。结论Medtronic Autoguide机器人可安全用于SEEG电极植入，并缩短了SEEG病例的预植入时间和每个电极的植入时间。然而，与CRW框架相比，我们初始队列的准确性降低了。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.