Frame for stereotactic surgery
First Claim
1. In a stereotactic instrument for neurosurgery of the brain for use with a noninvasive scanner such as a CT scanner having a moveable table, said instrument having a rigid frame, means for attaching the frame to the patient'"'"'s skull, means for determining scanner coordinates indicating a precise brain location from scanner measurements, means attached to said frame for defining a set of frame coordinates, and means attached to said frame for precisely guiding a surgical implement to said brain location in accordance with said scanner coordinates, the improvement comprising,means for releasably fastening said frame to said CT scanner table, andmeans for adjusting the plane of said frame to a predetermined position relative to the plane of said CT scanner table.
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Abstract
An improved stereotactic instrument for precise insertion of an electrode or a biopsy needle into the brain is designed for use with a computed tomographic (CT) scanner and does not require scanner software modification or complicated calculations to transfer the scanner coordinates of a desired brain location to the instrument. The instrument is based on a modified rectangular Gouda frame which can be temporarily attached to the CT scanner table by mounting plates that can be adjusted relative to one another until the frame is precisely aligned to the CT scanner zero reference plane. The frame is then affixed to the patient and after a plurality of CT scans are taken to establish the coordinates of the desired brain location, the patient and frame are detached from the CT table and moved to the operation room where coordinate arms and a electrode/needle holding arc are placed on the frame. The target coordinates obtained from the CT scanner can then be set directly on the coordinate arms of the frame.
319 Citations
28 Claims
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1. In a stereotactic instrument for neurosurgery of the brain for use with a noninvasive scanner such as a CT scanner having a moveable table, said instrument having a rigid frame, means for attaching the frame to the patient'"'"'s skull, means for determining scanner coordinates indicating a precise brain location from scanner measurements, means attached to said frame for defining a set of frame coordinates, and means attached to said frame for precisely guiding a surgical implement to said brain location in accordance with said scanner coordinates, the improvement comprising,
means for releasably fastening said frame to said CT scanner table, and means for adjusting the plane of said frame to a predetermined position relative to the plane of said CT scanner table.
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8. In a stereotactic instrument for neurosurgery of the brain for use with a noninvasive scanner such as a CT scanner having a moveable table, said instrument having a rigid frame, means for attaching the frame to the patient'"'"'s skull, means for determining scanner coordinates indicating a precise brain location from scanner measurements, means attached to said frame for defining a set of frame coordinates, and means attached to said frame for precisely guiding a surgical implement to said brain location in accordance with said scanner coordinates, the improvement comprising,
a first attachment plate, means for rigidly attaching said first plate to said scanner table, a second attachment plate, means for rigidly attaching said second plate to said frame, means for moveably connecting said first plate to said second plate, means for adjusting the plane of said first plate relative to the plane of said second plate so that the plane of said frame can be adjusted to a predetermined position relative to the plane of said CT scanner table.
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11. A stereotactic instrument for neurosurgery of the brain for use with a noninvasive scanner such as a CT scanner having a moveable table and means for determining scanner coordinates indicating a precise brain location, said instrument comprising,
a rigid frame, means for attaching the frame to the patient'"'"'s skull, means attached to said frame for defining a set of frame coordinates, means attached to said frame for precisely guiding a surgical implement to said brain location in accordance with said frame coordinates, a first attachment plate, means for rigidly attaching said first plate to said scanner table, a second attachment plate, means for rigidly attaching said second plate to said frame, means for moveably connecting said first plate to said second plate, means for adjusting the plane of said first plate relative to the plane of said second plate so that the plane of said frame can be adjusted to a predetermined position relative to the plane of said CT scanner table.
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28. In a stereotactic instrument for neurosurgery of the brain, said instrument having a rigid frame, means for attaching the frame to the patient'"'"'s skull, means for determining coordinates of a lesion areas of the brain, an arc attached to said frame for precisely guiding a surgical implement to said brain location in accordance with said frame coordinates, the improvement comprising,
a surgical implement holder connected to said arc, said implement holder comprising, a graduated slider, means for removably attaching said slider to said arc, an implement carrier, means for slidably attaching said implement carrier to said slider, and a calibrated micrometer drive means for advancing said surgical implement a precise distance relative to said slider, whereby said carrier can be preset to a precise location relative to said slider and said slider together with said carrier can be removed from said arc during setup of said instrument prior to surgery and replaced for surgery while maintaining said preset location.
Specification