Quantification and Comparison of Neurosurgical Approaches in the Anatomy Laboratory: Description and Validation of a Novel, Navigation-based Method

Background: Anatomical studies are an essential part of surgical innovation and evaluation. A common limitation of most available research methods for the comparison of neurosurgical approaches in the anatomy laboratory is the lack of volumes visualization and quantification.

Objective: To describe the development and validation of a neuronavigation-based method, which allows the quantification of the anatomical features that define an approach, as well as the real-time visualization of the surgical pyramid.

Methods: The method was initially developed with commercially available hardware for coordinates collection (a digitizer and a frameless navigation system) and software for volume rendering; a dedicated neuronavigation software (ApproachViewer, part of GTx-UHN) was then developed. The accuracy of measurements (distances, areas, volumes) and the possibility of 3D rendering of surgical approaches simulated in a phantom were compared among the three different methods and a commercially available radiological software.

ApproachViewer was tested in the anatomy laboratory for the analysis of multiple neurosurgical approaches.

Results: The method accuracy depends on the navigation registration: with a 1–2 mm error it is adequate for the evaluation and comparison of most neurosurgical approaches. The accuracy is comparable to the one obtained with available radiological software.

In the anatomy laboratory the method appears versatile. The system can be easily used after brief training. ApproachViewer allows for a real time evaluation and comparison of surgical approaches, as well as post-dissection analyses of collected data.

Conclusions: This new research method and software allows visualization, quantification and comparison of neurosurgical approaches in the anatomy laboratory.