Tuesday, Nov. 9, 2004
RICHMOND, Va.
(Nov. 9, 2004) – A Virginia Commonwealth University Medical Center
neurosurgeon was the lead developer of a new piece of equipment that is
now being used by physicians in 20 hospitals around the world to perform
delicate surgical procedures deep inside the brain.
The new equipment,
which is about the size and weight of a plastic coffee cup, replaces a
bulky, halo-like stereotactic metal frame that had to be bolted to a
patient’s head and then to the operating table. The so-called
“frameless” device is being used in deep brain stimulation procedures,
highly precise surgical techniques that involve placing tiny electrodes
into remote areas of the brain to treat Parkinson’s Disease, tremors and
dystonia, which is characterized by involuntary twisting body movements
or postures.
The NeXframe
device – a small, lightweight plastic tower that affixes to a patient’s
head during surgery to support surgical instruments – was developed
through a collaboration among VCU neurosurgeon, Kathryn Holloway, M.D.;
Jaimie Henderson, M.D., a neurosurgeon from Cleveland Clinic; and Image
Guided Neurologics, a medical-equipment development firm. Holloway and
her colleagues recently presented results of a two-year study of the
device at international movement disorders conferences in Rome and
Vienna.
“The new frameless
method for performing deep brain stimulation is truly a revolution for
this area of neurosurgery,” said Holloway. “The frameless device offers
surgeons equal accuracy with the previous equipment, while making
patients, who must remain awake for the surgery, much more
comfortable.”
Deep brain
stimulation is an interactive procedure that requires surgeons to
pinpoint precise areas inside the brain that are misfiring. Tiny
electrodes are implanted into the brain and then connected to a
pacemaker that can be programmed to “turn off” the areas that are
causing tremors or walking difficulty. During surgery, patients are
asked to make eye contact with doctors and to perform various movements
so surgeons can identify the areas of the brain that need treating.
Holloway said the frameless configuration makes patient movement much
easier and allows them to shift positions during the six- to eight-hour
operation.
In addition to
patient comfort, Holloway said the frameless configuration also reduces
surgery time by about two hours, since the magnetic resonance imaging
and computed tomography scans required to map the brain before surgery
can be done days in advance. Previously, brain scans had to be done
once the large frame was in place.
The new device
fits into a larger trend in neurosurgery toward frameless stereotactic
neurosurgery, a method adopted for other similar types of procedures
more than 10 years ago. Surgeons had been reluctant to abandon the large
metal frames because of the high-accuracy requirements of deep brain
stimulation, often in the 1-millimeter to 2-millimeter range.
“Until now, the
theory has been that the large frame was the best way to stabilize the
patient and support surgical instruments,” said Holloway. “Now we’re
able to do both, while making the patient more comfortable.”
About VCU and VCU Medical Center
Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 226 degree and certificate programs in the arts, sciences and humanities. Sixty-seven of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University comprise VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.