By Wendy Grafius, contributing writer
Implementation enables doctors to observe surgical instruments and exact target location during operation in real time, allowing patients to sleep through surgery and reduce anxiety associated
Cook Children’s Medical Center has become the first pediatric hospital in the nation to offer asleep deep brain stimulation (DBS) surgery to children afflicted with dystonia. Combining technologies from MRI Interventions and IMRIS, the neurosurgical procedure is part of a comprehensive Movement Disorder program at Cook Children’s and represents a groundbreaking collaboration of technology for improved patient quality of life.
Physiological and movement disorders such as essential tremor and dystonia are debilitating neurological illnesses that cause involuntary muscle contractions and painful muscle contortions. For some patients, medication does not provide adequate treatment, leading to DBS as an important therapeutic option. DBS involves implanting electrodes into the brain and a brain “pacemaker” under the skin of the chest and normally, in a second surgery, connecting the two. Additionally, the therapy is typically performed on awake patients so that the surgeon can assess placement of the wires by observing the effect of stimulation in certain areas of the brain. Unfortunately, dystonia patients and children, in particular, do not tolerate this procedure well due to involuntary movements and the anxiety of awake surgery.
At Cook Children’s, clinicians are utilizing the VISIUS Surgical Theatre image guided therapy solution from IMRIS and combining it with MRI Interventions’ ClearPoint platform for performing minimally invasive surgical procedures. “The VISIUS iMRI and ClearPoint guidance platform make DBS surgery an option for these children,” said Dr. John Honeycutt, Cook Children’s department of neurosurgery’s medical director who performed the first two pediatric asleep DBS procedures in November 2013. “It is very difficult for children to remain awake during surgery, and the real-time intraoperative visualization and guidance we use with these technologies means they do not have to.”
The VISIUS iMRI at Cook Children’s brings high-field MRI on ceiling-mounted rails. The scanner moves between the operating room and a diagnostic room and provides high resolution MR images throughout the procedure without moving the patient. MRI Interventions’ ClearPoint enables minimally-invasive neurosurgical procedures under constant MRI guidance with superior soft tissue visualization. The clinician is able to visualize and choose the neurological target, determine a trajectory, and see the target on MR images as the electrode is inserted.
“As one of a select group of pediatric neurosurgical centers with an IMRIS iMRI today and one of the largest neurosurgical programs in the Southwest, we continue to demonstrate our institution’s commitment to the care of children with these complex neurological disorders,” said Honeycutt. “Our adoption of the ClearPoint system in the VISIUS iMRI to enable asleep DBS for these young patients is representative of this commitment.”
With nearly a century of service to North Texas, Cook Children’s Health Care System is a nonprofit pediatric organization composed of eight nationally-recognized companies: a 429-bed medical center, physician network, home health company, Northeast Hospital, pediatric surgery center, health plan, Health Services, Inc., and a health foundation. Based in Fort Worth, Texas, the system serves residents of six counties at more than 60 primary and specialty care locations, with additional referrals from approximately half of the expansive state. The medical center is one of seven pediatric hospitals nationwide to be named a Leapfrog Group’s Top Hospital, and has achieved Level II Trauma distinction. It has earned the Joint Commission’s Gold Seal of Approval and has Magnet designation. Additionally, Cook Children’s is the only free-standing pediatric healthcare network to make the 2010 Top 100 Integrated Healthcare Networks (IHN).
SOURCE: PR Newswire
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