Stereotactic Frame-Based Electrode Insertion: The Accuracy of Increasingly Oblique Insertion Angles

Zachary D. GILBERT; Austin M. TANG; Terrance PENG; Li DING; Emiliano TABARSI; Jonathan CAVALERI; Andrea LEONOR; Roberto Martin Del CAMPO-VERA; Arthur SHAO; Ryan CHUNG; Shivani SUNDARAM; Alexandra KAMMEN; Angad S. GOGIA; Charles Y. LIU; Spencer S. KELLIS; Brian LEE

doi:10.5137/1019-5149.JTN.42185-22.2

Issue release date: 08.03.2024

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Turkish Neurosurgery 2024 , Vol 34 , Num 1

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Stereotactic Frame-Based Electrode Insertion: The Accuracy of Increasingly Oblique Insertion Angles

Zachary D. GILBERT¹,Austin M. TANG¹,Terrance PENG¹,Li DING¹,Emiliano TABARSI¹,Jonathan CAVALERI¹,Andrea LEONOR¹,Roberto Martin Del CAMPO-VERA¹,Arthur SHAO¹,Ryan CHUNG¹,Shivani SUNDARAM¹,Alexandra KAMMEN¹,Angad S. GOGIA¹,Charles Y. LIU²,Spencer S. KELLIS²,Brian LEE²

¹University of Southern California, Keck School of Medicine of USC, Department of Neurological Surgery, Los Angeles, CA, United States
²USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, United States DOI : 10.5137/1019-5149.JTN.42185-22.2 AIM: To investigate the relationship between planned drill approach angle and angular deviation of the stereotactically placed intracranial electrode tips.

MATERIAL and METHODS: Stereotactic electrode implantation was performed in 13 patients with drug resistant epilepsy. A total of 136 electrodes were included in our analysis. Stereotactic targets were planned on pre-operative magnetic resonance imaging (MRI) scans and implantation was carried out using a Cosman-Roberts-Wells stereotactic frame with the Ad-Tech drill guide and electrodes. Post implant electrode angles in the axial, coronal, and sagittal planes were determined from post-operative computerized tomography (CT) scans and compared with planned angles using Bland-Altman plots and linear regression.

RESULTS: Qualitative assessment of correlation plots between planned and actual angles demonstrated a linear relationship for axial, coronal, and sagittal planes, with no overt angular deflection for any magnitude of the planned angle.

CONCLUSION: The accuracy of CRW frame-based electrode placement using the Ad-Tech drill guide and electrodes is not significantly affected by the magnitude of the planning angle. Based on our results, oblique electrode insertion is a safe and accurate procedure. Keywords : Oblique, Orthogonal, Stereotactic, Depth electrode, Cosman-Roberts-Wells

Corresponding author : Zachary D. GILBERT, zgilbert@usc.edu