Operative Neurosurgery 29:93–101, 2025
Intraoperative O-arm imaging with the NaviNetics stereotactic head frame enables accurate, efficient deep brain stimulation (DBS) lead placement in both awake and asleep surgeries, streamlining workflow by eliminating patient transport for imaging and achieving submillimeter accuracy comparable to traditional CT-based methods.
• The study evaluates the NaviNetics stereotactic head frame system with intraoperative O-arm imaging for deep brain stimulation (DBS) surgery.
• Intraoperative O-arm imaging was used for both stereotactic registration and lead placement confirmation in awake and asleep DBS procedures.
• A total of 17 patients were included; 1 had both CT and O-arm, while 16 had only O-arm localization.
• Accuracy of O-arm imaging was comparable to traditional CT, with less than 0.1 mm difference and a mean radial error of 0.71 ± 0.33 mm for 32 leads.
• No surgical complications, lead repositioning, or infections were reported.
• The intraoperative O-arm workflow reduces patient transport, surgical time, and allows real-time confirmation of lead placement.
• Limitations include limited hemorrhage detection by O-arm and lack of direct comparison with stereotactic CT in larger samples.
• The study concludes O-arm imaging is safe, effective, and streamlines DBS surgery without compromising accuracy.
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