{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:40:41Z","timestamp":1791664841198,"version":"4.3.4"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Frame-based stereotactic interventions are considered the gold standard for brain biopsies, but they have limitations with regard to flexibility and patient comfort because of the bulky head ring attached to the patient. Frameless image guidance systems that use scalp fiducial markers offer more flexibility and patient comfort but provide less stability and accuracy during drilling and biopsy needle positioning. Head-mounted robot-guided biopsies could provide the advantages of these 2 techniques without the downsides. The goal of this study was to evaluate the feasibility and safety of a robotic guidance device, affixed to the patient\u2019s skull through a small mounting platform, for use in brain biopsy procedures.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This was a retrospective study of 37 consecutive patients who presented with supratentorial lesions and underwent brain biopsy procedures in which a surgical guidance robot was used to determine clinical outcomes and technical procedural operability.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The portable head-mounted device was well tolerated by the patients and enabled stable drilling and needle positioning during surgery. Flexible adjustments of predefined paths and selection of new trajectories were successfully performed intraoperatively without the need for manual settings and fixations. The patients experienced no permanent deficits or infections after surgery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The head-mounted robot-guided approach presented here combines the stability of a bone-mounted set-up with the flexibility and tolerability of frameless systems. By reducing human interference (i.e., manual parameter settings, calibrations, and adjustments), this technology might be particularly useful in neurosurgical interventions that necessitate multiple trajectories.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.12.jns141781","type":"journal-article","created":{"date-parts":[[2015,6,12]],"date-time":"2015-06-12T14:48:19Z","timestamp":1434120499000},"page":"737-742","source":"Crossref","is-referenced-by-count":42,"title":["Blurring the boundaries between frame-based and frameless stereotaxy: feasibility study for brain biopsies performed with the use of a head-mounted robot"],"prefix":"10.3171","volume":"123","author":[{"given":"Florian","family":"Grimm","sequence":"first","affiliation":[{"name":"Division of Functional and Restorative Neurosurgery, Department of Neurosurgery, Eberhard Karls University, Tuebingen; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Naros","sequence":"additional","affiliation":[{"name":"Division of Functional and Restorative Neurosurgery, Department of Neurosurgery, Eberhard Karls University, Tuebingen; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Gutenberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johannes Gutenberg University, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naureen","family":"Keric","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johannes Gutenberg University, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alf","family":"Giese","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johannes Gutenberg University, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Gharabaghi","sequence":"additional","affiliation":[{"name":"Division of Functional and Restorative Neurosurgery, Department of Neurosurgery, Eberhard Karls University, Tuebingen; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns141781","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"820","DOI":"10.3171\/2009.3.JNS081695","article-title":"Comparing the risks of frameless stereotactic biopsy in eloquent and noneloquent regions of the brain: a retrospective review of 284 cases","volume":"111","author":"Air","year":"2009"},{"key":"b2-jns141781","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.3171\/2010.7.JNS091493","article-title":"Image-guided frameless stereotactic needle biopsy in awake patients without the use of rigid head fixation","volume":"114","author":"Amin","year":"2011"},{"key":"b3-jns141781","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.nec.2009.04.006","article-title":"Devices for targeting the needle","volume":"20","author":"Barbre","year":"2009"},{"key":"b4-jns141781","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.3171\/2012.1.JNS111746","article-title":"Frameless robotically targeted stereotactic brain biopsy: feasibility, diagnostic yield, and safety","volume":"116","author":"Bekelis","year":"2012"},{"key":"b5-jns141781","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"160","DOI":"10.3171\/jns.1999.90.1.0160","article-title":"Accuracy of true frameless stereotaxy: in vivo measurement and laboratory phantom studies. 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