Application of modified registration for osseous fiducial marker in operation of deep brain stimulation assisted by ROSA robot

Abstract

Objective To further reduce the registration error of ROSA by the application of corrective registration for fiducial osseous marker. Methods Thirty-four patients, including 33 Parkinson’s disease patients and 1 essential tremor patient, were admitted to Department of Neurosurgery, General Hospital of Shenyang Military Area Command from November 2016 to January 2017 and underwent DBS (deep brain stimulation) operation assisted by ROSA. Each of them was registered by contact with 5-point titanium alloy markers. Each patient received 4 registration plans which were respectively named group A, group B, group C and group D. The virtual probe circles in group A were tangent to the end of the marker image on CT. The virtual probe circles in group B, group C and group D were individually moved by 0.25 mm, 0.50 mm and 0.75 mm to the marker tip along the long axis based on group A. The registration errors in each group were documented and 4 sets of error data were analyzed by variance analysis. Results The registration errors in group A ranged from 0.47 mm to 0.77mm, with an average of 0.60±0.08 mm. The registration errors in group B ranged from 0.15 mm to 0.68 mm, with an average of 0.39±0.12 mm. The registration errors in group C ranged from 0.11 mm to 0.39 mm, with an average of 0.27±0.08 mm. The registration errors in group D ranged from 0.22 mm to 0.66 mm, with an average of 0.43±0.10 mm. The population means in the 4 groups were not completely equal by variance analysis (F=68.024, P<0.001). Significant difference was identified in registration errors between any 2 groups except for that between the group B and D. The registration error in group C was the smallest and that in group A was the largest. The registration errors in group B and D were between them. Conclusions Registration error decreases when the virtual probe circle is moved by 0.50 mm to the tip of markers along the long axis of markers in the DBS operation assisted by ROSA. The modified registration plan could improve the accuracy of DBS operation. Key words: Deep brain stimulation; Robotics; Registration error