BACKGROUND: The "frameless" NeXframe device is a small, lightweight plastic tower that attaches to a patient's head during surgery to support surgical instruments, thereby improving patient comfort and reducing surgical time. It is now being used by physicians in 20 hospitals around the world to perform delicate surgical procedures deep inside the brain.
HOW IT WORKS: About the size and weight of a plastic coffee cup, the new equipment is meant to replace to very bulky metal frame normally bolted to a patient's head and then to the operating table. The frameless device is especially useful in deep brain stimulation procedures, which require a great deal of precision because they involve placing tiny electrodes into remote areas of the brain to treat such problems as Parkinson's disease, tremors, and dystonia (involuntary twisting body movements or postures). Frameless devices are increasingly being used in neurosurgery, but surgeons had been reluctant until now to abandon the old method of large metal frames because stimulating the deep parts of the brain require that surgeons touch points accurately. The frameless configuration allows patients to shift positions during the operation, which can last 6 to 8 hours, although it can also reduce surgical time to about two hours, because the MRI and CAT scan images of the brain can be made days in advance, rather than once the large bolted frame is in place.
ABOUT DEEP BRAIN STIMULATION: 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 difficulty walking. During surgery, patients are asked to make eye contact with doctors and to perform various movements so surgeons can identify those areas of the brain in need of treatment.
ABOUT CAT SCANS: CAT (Computerized Axial Tomography) scans are similar to conventional X-ray imaging, but instead of imaging the outline of bones and organs, a CAT scan machine forms a full three-dimensional computer model of the inside of a patient's body. Doctors can even examine the body one narrow slice at a time. The X-ray beam moves all around the patient, scanning from hundreds of different angles, and the computer takes all that information to compile a 3D image of the body.