Principles of Stereotactic Surgery

Authors

Michael A. Jensen, Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA.
Joseph S. Neimat, Department of Neurosurgery, University of Louisville, Louisville , Kentucky , USA.
Panagiotis Kerezoudis, Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA.
Rushna Ali, Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA.
R Mark Richardson, Department of Neurosurgery, Massachusetts General Hospital, Boston , Massachusetts , USA.
Casey H. Halpern, Department of Neurosurgery, University of Pennsylvania, Philadelphia , Pennsylvania , USA.
Steven G. Ojemann, Department of Neurosurgery, University of Colorado Health Neurosciences Center, Denver , Colorado , USA.
Francisco A. Ponce, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix , Arizona , USA.
Kendall H. Lee, Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA.
Laura M. Haugen, Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA.
Fiona E. Permezel, Department of Neurology, Mayo Clinic, Rochester , Minnesota , USA.
Bryan T. Klassen, Department of Neurology, Mayo Clinic, Rochester , Minnesota , USA.
Douglas Kondziolka, Department of Neurosurgery, NYU Langone Health, New York , New York , USA.
Kai J. Miller, Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA.

Document Type

Article

Abstract

BACKGROUND AND OBJECTIVES: Stereotactic procedures are used to manage a diverse set of patients across a variety of clinical contexts. The stereotactic devices and software used in these procedures vary between surgeons, but the fundamental principles that constitute safe and accurate execution do not. The aim of this work is to describe these principles to equip readers with a generalizable knowledge base to execute and understand stereotactic procedures. METHODS: A combination of a review of the literature and empirical experience from several experienced surgeons led to the creation of this work. Thus, this work is descriptive and qualitative by nature, and the literature is used to support instead of generate the ideas of this framework. RESULTS: The principles detailed in this work are categorized based on 5 clinical domains: imaging, registration, mechanical accuracy, target planning and adjustment, and trajectory planning and adjustment. Illustrations and tables are used throughout to convey the concepts in an efficient manner. CONCLUSION: Stereotactic procedures are complex, requiring a thorough understanding of each step of the workflow. The concepts described in this work enable functional neurosurgeons with the fundamental knowledge necessary to provide optimal patient care.

Medical Subject Headings

Humans; Stereotaxic Techniques; Neurosurgical Procedures (methods)

Publication Date

3-1-2025

Publication Title

Operative neurosurgery (Hagerstown, Md.)

E-ISSN

2332-4260

Volume

28

Issue

3

First Page

303

Last Page

321

PubMed ID

39627171

Digital Object Identifier (DOI)

10.1227/ons.0000000000001422

Recommended Citation

Jensen, Michael A.; Neimat, Joseph S.; Kerezoudis, Panagiotis; Ali, Rushna; Richardson, R Mark; Halpern, Casey H.; Ojemann, Steven G.; Ponce, Francisco A.; Lee, Kendall H.; Haugen, Laura M.; Permezel, Fiona E.; Klassen, Bryan T.; Kondziolka, Douglas; and Miller, Kai J., "Principles of Stereotactic Surgery" (2025). Neurosurgery. 2281.
https://scholar.barrowneuro.org/neurosurgery/2281