Neuronavigation
Encyclopedia
The term neuronavigation is a neologism used to describe the set of computer-assisted technologies used by neurosurgeons to guide or "navigate” within the confines of the skull or vertebral column during surgery. The term is also used in a more universal sense outside the field of neurosurgery
in areas of medicine such as otorhinolaryngology (ENT), orthopedics, general surgery and urology, with similar purposes in different anatomical areas. The set of hardware for these purposes is referred to as a neuronavigator.
, a set of techniques that dates back to the early 1900s and that gained popularity during the 1940s, particularly in Germany, France and the U.S., with the development of surgery for the treatment of movement disorders such as Parkinson's disease
and dystonia
s. In its infancy the purpose of this technology was to create a mathematical model describing a proposed coordinate system for the space within a closed structure, e.g., the skull. This "fiducial spatial coordinate system” uses fiduciary marker
s as a reference to describe with high accuracy the position of specific structures within this arbitrarily defined space. The surgeon then refers to that data in order to target particular structures within the brain. This technology was boosted by the collection of data on human anatomy in “stereotactic atlases”, expanding the quantitatively defined “targets” that could be readily used in surgery. Finally, the advent of modern neuro-imaging technologies such as computed tomography
(CT) and magnetic resonance imaging
(MRI)—along with the ever-increasing capabilities of digitalization, computer-graphic modelling and accelerated manipulation of data through complex mathematical algorithms via robust computer technologies—made possible the real-time quantitative spatial fusion of images of the patient's brain with the created “fiducial coordinate system” for the purpose of guiding the surgeon's instrument or probe to a selected target. In this way the observations done via highly sophisticated neuro-imaging technologies (CT, MRI, angiography) are related to the actual patient during surgery.
, and new and better algorithms to handle data via more sophisticated computer technology.
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
in areas of medicine such as otorhinolaryngology (ENT), orthopedics, general surgery and urology, with similar purposes in different anatomical areas. The set of hardware for these purposes is referred to as a neuronavigator.
Stereotactic Surgery
Neuronavigation is recognized as the next evolutionary step of stereotactic surgeryStereotactic surgery
Stereotactic surgery or stereotaxy is a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinates system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation,...
, a set of techniques that dates back to the early 1900s and that gained popularity during the 1940s, particularly in Germany, France and the U.S., with the development of surgery for the treatment of movement disorders such as Parkinson's disease
Parkinson's disease
Parkinson's disease is a degenerative disorder of the central nervous system...
and dystonia
Dystonia
Dystonia is a neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. The disorder may be hereditary or caused by other factors such as birth-related or other physical trauma, infection, poisoning or reaction to...
s. In its infancy the purpose of this technology was to create a mathematical model describing a proposed coordinate system for the space within a closed structure, e.g., the skull. This "fiducial spatial coordinate system” uses fiduciary marker
Fiduciary marker
A fiducial marker or fiducial is an object used in the field of view of an imaging system which appears in the image produced, for use as a point of reference or a measure...
s as a reference to describe with high accuracy the position of specific structures within this arbitrarily defined space. The surgeon then refers to that data in order to target particular structures within the brain. This technology was boosted by the collection of data on human anatomy in “stereotactic atlases”, expanding the quantitatively defined “targets” that could be readily used in surgery. Finally, the advent of modern neuro-imaging technologies such as computed tomography
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
(CT) and magnetic resonance imaging
Magnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...
(MRI)—along with the ever-increasing capabilities of digitalization, computer-graphic modelling and accelerated manipulation of data through complex mathematical algorithms via robust computer technologies—made possible the real-time quantitative spatial fusion of images of the patient's brain with the created “fiducial coordinate system” for the purpose of guiding the surgeon's instrument or probe to a selected target. In this way the observations done via highly sophisticated neuro-imaging technologies (CT, MRI, angiography) are related to the actual patient during surgery.
Neuro Imaging
The ability to relate the position of a real surgical instrument in the surgeon’s hand or the microscope’s focal point to the location of the imaged pathology, updated in “real time” in an "integrated operating room", highlights the modern version of this set of technologies at its finest. In its current form, neuronavigation began in the 1990s and has adapted to new neuro-imaging technologies, real-time imaging capabilities, new technologies to transfer the information in the operating room for 3-D localization, real-time neuro-monitoring, roboticsRobotics
Robotics is the branch of technology that deals with the design, construction, operation, structural disposition, manufacture and application of robots...
, and new and better algorithms to handle data via more sophisticated computer technology.