神经导航在颅内病变微创手术中的应用价值

目的探讨神经导航技术在颅内病变显微神经外科手术中的应用价值。方法32例颅内肿瘤和血管性病变患者，经术前MRI薄层扫描（1mm／层）或CT薄层扫描（1mm／层）检查，将影像数据输入Stryker导航系统工作站，进行三维重建（包括头皮、病灶、重要功能区及标志点），靶点设定，手术切口人路设计，精确定位微小病灶位置，术中神经导航引导下确定病灶位置及范围，以显微神经外科技术切除病变，术后进行临床评估和影像学评价。结果应用神经导航对颅内病变、重要结构定位准确，定位误差均在3mm以内。32例手术导航下寻找病变成功率达100％，病变全切除率达90％，同时未发生严重神经功能损害。结论神经导航系统能提供精确的术前手术人路设计和术中实时导向，减少手术创伤，提高手术效果，降低死亡率、病残率，在微创神经外科手术中具有重要的临床应用价值。

Application value of neuronavigation-guided minimally invasive neurosurgery in resection of intracranial lesions

Objective To study the application value of neuronavigation-guided minimally invasive neurosurgery. Methods A total of 32 patients with skulls tumor and vascular pathological changes received the preoperative inspection of MRI thin layer scanning （ 1 mm/layer） or CT thin scanning （ 1 mm/layer） and the phantom data were put into Stryker navigation system workstation. So the three dimensional models were established （ including scalp, focus of infection, important function areas and mark point）, a target was fixed, the cut-in passage was designed, small focus of infection with high accuracy was located, and the focus of infection position and the scope were determined by the neurosurgery technology. After the lesions were removed by microsurgical techniques, the clinical and radiological evaluations were offered. Results The localization of skull-internal lesions and the important structures had been accurately determined with location error less than 3.0 mm. The success ratio got to 100% for finding lesions and 90% for total removal of lesions in all the 32 cases with the application of neurosurgery technology. Meanwhile, any severe neural- function damage had not taken place. Conclusion The neurosurgery system provides the optimal surgical approach and the synchronized guidance in operation, reduces the surgical lesions, improves the surgery efficacy, and depresses the mortality, sick and disabled rate. It has important clinical value in the minimally invasive surgery.