8 research outputs found
Neuronavigation in a developing country: A pilot study of efficacy and limitations in intracranial surgery
Context: Neuronavigation provides a patient-specific, three-dimensional
(3-D) anatomy for preoperative planning and intraoperative navigation.
However, the initial and maintenance costs are quite prohibitive,
especially in the Indian scenario. Aims : To study the efficacy and
limitations of neuronavigation, especially in the Indian scenario.
Settings and Design: A prospective nonrandomized study. Materials and
Methods : A total of 121 patients underwent intracranial surgery from
2002-2006, in which neuronavigation was used. In this, the initial
part, we studied the efficacy and limitations of neuronavigation in the
initial 37 patients. The efficacy of the image guidance was graded
according to a point′s scale in which points were awarded ranging
from 0 to 3. Cranial image guided score (IGS) was calculated by the
summation of grading during designing the flap/burr hole, delineation
of the intraoperative anatomy, navigation and access to the lesion and
resection / biopsy of the lesion or completion of the procedure. The
scoring ranged from 0-12 and the utility of IGS in cranial
neurosurgical procedures was calculated based on the total points for
each surgery. Results and Conclusion : Cranial image guidance was
useful in a variety of operative steps. Intraoperative approach and
navigation was relatively easier with an increase in perception of
safety. Limitations of IGS include learning curve, cost and the
phenomenon of brain shift. Drawbacks of the study included that this
was a subjective rather than a truly objective study and the relatively
lesser number of patients. We hope to conduct a larger study with
randomization but the question of ethical approval would be a primary
concern