Frameless, pinless stereotactic neurosurgery in children.

Abstract

Frameless neuronavigation has been established as a useful adjunct to intracranial surgery; however, the procedure is limited in young children by the need for rigid skull fixation with pins. Pin fixation is difficult and hazardous for patients younger than 2 years of age. Minor risks have been associated with pin fixation in older patients also, including scalp laceration, skull fracture, and epidural hematoma. The authors adapted a pinless head fixation system, consisting of a beanbag device, for use with frameless neuronavigation. This system was used to perform intracranial neurosurgical procedures in nine patients. This pinless, frameless method provides a new option for children who are unable to sustain rigid head fixation. It is also an alternative to rigid pin fixation for patients of any age.