Integration of multimodality imaging and surgical navigation in the management of patients with refractory epilepsy. A pilot study using a new minimally invasive reference and head-fixation system.

Objective: To review the experience with a new system (VBH system) for minimally invasive frameless stereotactic guidance, acting as a common platform to provide multimodal image integration and surgical navigation in a consecutive series of 25 patients who underwent surgery for drug-resistant seizures.

Methods: The usefulness of the VBH system for integrating all images to produce one dataset and for intraoperative instrument guidance and navigation was judged semiquantitatively in a three-tiered scale (+, ++, +++). Seizure outcome was classified according to Engel.

Frameless stereotactic placement of foramen ovale electrodes in patients with drug-refractory temporal lobe epilepsy.

Objective: Semi-invasive foramen ovale electrodes (FOEs) are used as an alternative to invasive recording techniques in the presurgical evaluation of patients with temporal lobe epilepsy. To maximize patient safety and interventional success, frameless stereotactic FOE placement by use of a variation of an upper jaw fixation device with an external fiducial frame, in combination with an aiming device and standard navigation software, was evaluated by the Innsbruck Epilepsy Surgery Program.

Methods: Patients were immobilized noninvasively with the Vogele-Bale-Hohner headholder (Medical Intelligence GmbH, Schwabmünchen, Germany) to plan computed tomography and surgery.

Accuracy of stereotactic electrode placement in deep brain stimulation by intraoperative computed tomography.

The purpose of this study was to evaluate the accuracy of stereotactic electrode placement in patients undergoing deep brain stimulation by using pre- and postoperative computed tomography (CT). Twenty-three patients with movement disorders (Parkinson's disease (n=7), tremor (n=9), dystonia (n=7)) treated with bilateral deep brain stimulation (DBS) (overall 46 target points) were investigated. The target point of the electrode was planned stereotactically in combination with a preoperative stereotactic helical computed tomography (CT).

Long-term outcome of laminectomy for spinal stenosis in octogenarians.

Study Design: Cohort study with follow-up after at least 1.5 years.

Objectives: The purpose of this study was to determine long-term safety and efficacy of laminectomy in octogenarians.

Neuroendoscopy based on computer assisted adjustment of the endoscope holder in the laboratory.

Objective: We present our initial clinical experience with a novel technique of frameless stereotactic neuroendoscopy using a neuronavigation system, a specially designed aiming device (endoscope holder/targeting device) combined with a vacuum-mouthpiece based head holder. Due to the reproducibility of patient immobilization in the fixation system, the endoscope holder can be adjusted in the laboratory in the absence of the patient.

Methods: An individual vacuum-mouthpiece was fabricated.