应用立体定向和神经外科导航系统治疗症状性癫痫

多坐标控制器（ＭＫＭ）与外科显微镜（Ｓｕｒｇｉｓｃｏｐｅ）为无框架立体定向导航系统，可与ＣＴ或ＭＲ连接进行图像引导的手术导航。应用导航系统和Ｆｉｓｃｈｅｒ立体定向仪治疗１３例癫痫患者，用ＣＴ图像引导，并对其实用性、可信性、实时导航的准确性以及与传统神经外科手术连接的方法进行了评估。结果发现此两种导航系统准确性高、实用性强、误差小于２ｍｍ。神经外科导航系统有广泛适应证如：胶质瘤切除、脑积水分流术、皮质下小病变切除术等。本文讨论了两种导航系统的优缺点。Ｆｉｓｃｈｅｒ立体定向仪使用方便，价格相对低廉，适应于广大基层医院。

Clinical use of frameless neurosurgery navigation for surgery of the intracranicl lesions

The multicoordinate manipulator (MKM) microscope and Surgiscope system are frameless stereotactic system that can be used in conjunction with computerized tomography (CT) or magnetic resonance (MR) imaging to provide image baseed introperative navigation. The authors report a series of 13 patients urith epilepsy in which the two navigation systems and Fischer stereotactic instrument were used and evaluated for its utility, ease of integration into standard surgucal setup, reliablity and real world accuracy. The navigation system were used in conjunction with CT. We found that the navigation systems were reliable and accurate, their error was less than 2mm. The systems were sufficient for a broad range of applications including glioma resection, cerebrosponal fluid shunting procedures, resection of small subcortical masses and temporal resetion. The advantage and disadvantages of the two systems were discussed. Using Fischer stereotactic instument is convinient and its price is relative low which is suitble for broad basic hospital.