Accuracy study of electrode implantation of robot-assisted deep brain stimulation based on visual registration

Objective To evaluate the accuracy and safety of electrode implantation of deep brain stimulation (DBS) with visual registration-based robot assistance. Methods The clinical data of 15 patients with Parkinson′s disease (PD) admitted to Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from October 2018 to June 2019 were retrospectively analyzed. All those patients underwent DBS assisted with neurosurgical robot (Remebot system). The distance deviations of implanted electrodes in the lateral direction (x-axis) and longitudinal direction (y-axis) were documented according to postoperative CT fused with preoperative imaging of surgical plan. Postoperative complications were documented as well. Results A total of 30 DBS electrodes were successfully implanted in 15 patients. Twenty-six electrodes were implanted into the subthalamic nucleus and 4 into the globus pallidus internus. The x-axis distance deviation between the tip of electrode and planned target ranged from 0.10 mm to 1.34 mm, and the average distance deviation was 0.60±0.33 mm. The y-axis distance deviation ranged from 0.02 mm to 0.83 mm, and the average distance deviation was 0.45±0.24 mm. There were no electrode-related bleeding events, intracranial infection or surgical incision non-healing. Conclusion DBS with assistance of neurosurgical robot seems to be associated with relatively little deviation in electrode implantation and no surgery-related complications. Key words: Deep brain stimulation; Parkinson disease; Robotics; Accuracy