May 13, 2021
Compared with standard stereotactic magnetic resonance imaging (MRI) or computed tomography (CT), use of Medtronic’s O-arm device in deep brain stimulation surgery workflow reduced surgical time by more than an hour and operating room costs by nearly a third in patients with Parkinson disease and other movement disorders, according to a utility and cost-effectiveness study published online in Stereotactic and Functional Neurosurgery.
The study included 80 patients who received routine frame-based stereotactic deep brain stimulation surgery, which requires interoperative imaging for accurate placement of intracranial electrodes. Researchers from the King's College Hospital NHS Foundation Trust in London compared use of the O-arm for the acquisition of coordinates and verification of the position of electrodes with conventional stereotactic MRI or CT.
Patients in the study had Parkinson disease, dystonia, essential tremor, and epilepsy. The most commonly targeted region was the globus pallidus internus, according to the study, followed by the subthalamic nucleus.
“Stereotactic O-arm imaging,” researchers wrote, “reduced the overall surgical time by 68 minutes, reduced the length of time of acquisition of stereotactic images by 77%, reduced patient exposure to ionizing radiation by 24.2%, significantly reduced operating room costs per procedure by 31%, and increased the operating room and neuroradiology suite availability.”
Moreover, the significant reductions in image acquisition time, ionizing radiation exposure, and costs observed with O-arm imaging did not affect accuracy, they noted.
Furlanetti L, Hasegawa H, Oviedova A, et al. O-Arm Stereotactic Imaging in Deep Brain Stimulation Surgery Workflow: A Utility and Cost-Effectiveness Analysis. Stereotact Funct Neurosurg. 2021;99(2):93-106. doi:10.1159/000510344