gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Magnetic guided neuronavigation: A reliable method for tracking ventricular catheter tip

Magnetisch geführte Neuronavigation: Eine verlässliche Methode zur Navigation der Spitze von Ventrikelkathetern

Meeting Abstract

  • corresponding author Christian Schichor - Neurochirurgische Klinik der Ludwig-Maximilians-Universität München, Klinikum Großhadern, München
  • J. Witte - Brainlab AG, München
  • K. Schöller - Neurochirurgische Klinik der Ludwig-Maximilians-Universität München, Klinikum Großhadern, München
  • R. Goldbrunner - Neurochirurgische Klinik der Ludwig-Maximilians-Universität München, Klinikum Großhadern, München
  • J.-C. Tonn - Neurochirurgische Klinik der Ludwig-Maximilians-Universität München, Klinikum Großhadern, München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 08.84

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0367.shtml

Veröffentlicht: 23. April 2004

© 2004 Schichor et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Free-hand accurate placement of ventricular catheters can be difficult in cases of small ventricels, abnormal ventricular anatomy or occipital placement. Misplacement of the catheter due to deviation at the rigid ventricular ependyma cannot be controlled by conventional neuronavigation systems during insertion. The aim of this study was to evaluate the accuracy of a magnetic tracking system of the catheter tip compared to conventional optical guided neuronavigation systems.

Methods

The sensor (4 mm magnetic coil, diameter 0.95 mm) of the flexible stylet, placed at the tip of the instrument, was tracked by a 3D magnetic system (AURORA Tracking System, Northern Digital Inc controller®), based on a Kolibri® (Brainlab AG, Munich) Image Guidance System. The accuracy of the magnetic tracking system was compared to optical tracking by geometrical analysis, cadaver studies and in 30 patients with hydrocephalus of different origins. Possible intraoperative magnetic fields and metallic instruments were tested for their influence on the navigation system.

Results

In cadaver tests, the accuracy of the system was very similar to optical tracking systems (which only track the proximal end of the probe). Tracking the sensor at the tip of the instrument also enabled the system to control correct placement of the catheter even when the stylet bends during insertion. The influence of magnetic fields and metallic instruments in the operating theatre was low and could be easily avoided. In 30 patients with hydrocephalus the accuracy of magnetic neuronavigation was estimated to be below 5mm. Even in patients whose heads were not fixed in a rigid mayfield pin fixation, accuracy of the system was maintained.

Conclusions

Magnetic guided neuronavigation proved to be a very reliable method for the control of catheter tip, particularly in difficult cases. It represents a valuable addition to the present navigation systems that already exist.