Stealthstation s7

Manufactured by Medtronic

Sourced in United States, Ireland

The StealthStation S7 is a surgical navigation system designed to aid in the visualization and localization of anatomical structures during surgical procedures. It provides real-time, three-dimensional image guidance to assist surgeons in navigating the surgical site.

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Lab products found in correlation

Stealthmerge image registration, by Medtronic (2 mentions) O arm, by Medtronic (2 mentions) Libra system, by Abbott (2 mentions) Spss statistics version 26, by IBM (1 mentions) Nim eclipse, by Medtronic (1 mentions) Midas rex legend stylus, by Medtronic (1 mentions) Stealthstation s8, by Medtronic (1 mentions) Stealthviz, by Medtronic (1 mentions)

27 protocols using stealthstation s7

Mapping Glioma Molecular Profiles

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⁶⁸Ga-Pentixafor-PET/CT and T1-weighted rapid three-dimensional gradient-echo technique (MP-RAGE) MR images were transferred to a neuro-navigation system (Stealth Station S7, Medtronic Navigation, Louisville, USA) and combined in image fusion planning (StealthMerge Image Registration, Medtronic Navigation, Louisville, USA). During surgery of the gliomas, neuro-navigated biopsy specimens were obtained from areas with ⁶⁸Ga-Pentixafor uptake by three experienced neurosurgeons (M.L.; T.L.; A.F.K). In 5 cases, separate tumor samples with high and low/no tracer accumulation were biopsied, respectively.

Lapa C., Lückerath K., Kleinlein I., Monoranu C.M., Linsenmann T., Kessler A.F., Rudelius M., Kropf S., Buck A.K., Ernestus R.I., Wester H.J., Löhr M, & Herrmann K. (2016). 68Ga-Pentixafor-PET/CT for Imaging of Chemokine Receptor 4 Expression in Glioblastoma. Theranostics, 6(3), 428-434.

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Navigated Pedicle Screw Placement

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We also took L5/S1 segment as an example. All procedures were performed in the prone position under general anesthesia with the spine held in slight flexion. Patients received transcranial electrical stimulation-induced motor-evoked potentials (MEPs) and electromyography (EMG) monitoring during the operation. We used the O-arm (Medtronic, Inc.) to obtain AP and lateral plain radiographs to mark the bilateral pedicles of L5 and S1 roughly. Images were viewed on the StealthStation navigation system (StealthStation S7, Medtronic Inc.), which was positioned adjacent to the patient’s caudal site.
The surgical area was disinfected and covered with a sterile towel. The optical navigation reference frame (patient tracker) was fixed to the patient’s sacrum. A full O-arm spin was then performed to generate CT images (the tracker need to be included in the view). Then, the CT data were uploaded to the optical navigation workstation and surgical instruments which may be used were prepared after registration.

Xu D.R., Luan L.R., Ma X.X., Cong Z.C, & Zhou C.L. (2022). Comparison of electromagnetic and optical navigation assisted Endo-TLIF in the treatment of lumbar spondylolisthesis. BMC Musculoskeletal Disorders, 23, 522.

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Radiographic Assessment of Spinal Pedicle Screw Integrity

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At the end of each experiment, radiographic images of the anteroposterior and lateral views as well as axial and sagittal CT were obtained using an O-arm and StealthStation S7 (O-arm O2 Imaging System with software version 4.2.x, Medtronic Navigation, CO) operated by a certified radiology technician (Fig. 2, Fig. 3). For each experiment, the equipment acquired images at 30 frames per second, capturing approximately 391 projections in high resolution.
Subsequently, a fellowship-trained spine neurosurgeon performed laminectomies in all instrumented models (Fig. 4) and graded pedicle integrity according to the Abul-Kasim et al. classification (Fig. 5).
Three independent senior spine surgeons (blinded to the surgical procedure and participants) used a high-definition software to review and grade all radiographic and CT images obtained after screw placement. These results were compared with the grading obtained after open laminectomy.
The Abul-Kasim and colleagues classification grades cortical perforation as partial or complete and the location as lateral, medial, anterior, cranial, or caudal margins of the pedicle (Fig. 5). Pedicle screws classified into categories C, F, G, H, I, and K were considered unacceptable.
The data obtained was analyzed using Python and IBM SPSS Statistics Version 26.

Rosa Filezio M., Peiro-Garcia A., Parsons D.L., Thomas K, & Ferri-de-Barros F. (2023). Accuracy of imaging grading in comparison to open laminectomy to evaluate pedicle screws positioning. Annals of Medicine and Surgery, 86(1), 199-206.

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Prone Skull Base Surgery Monitoring

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The patient is placed prone with the head straight and secured in a Mayfield head holder. Neurophysiological monitoring (NIM-Neuro and NIM-Eclipse, Medtronic) and neuronavigation (StealthStation S7, Medtronic; or Brainlab Cranial 3.0) are set up. According to tumor extension, LCNs, cranial nerves VI and VII, and motor evoked potentials were monitored. The choice of the surgical side is made according to the most extensive condyle involvement, the largest lateral extension, and VA involvement.

Fava A., Russo P.D., Tardivo V., Passeri T., Câmara B., Penet N., Abbritti R., Giammattei L., Mammar H., Bernat A.L., Mandonnet E, & Froelich S. (2021). Endoscope-assisted far-lateral transcondylar approach for craniocervical junction chordomas: a retrospective case series and cadaveric dissection. Journal of neurosurgery, 135(5).

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Infarct Volume Extraction and Anatomic Relationship of Strip Electrode

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After standard clinical data were extracted, additional image analysis
was performed. Infarct volumes were extracted using semi-automated segmentation
(ITK SNAP 3.8.0[20 (link)]). The pre-operative
MRI with diffusion weighted (DWI) sequence was used for the baseline measurement
and the first head CT performed the day after strip electrode removal was used
for the final measurement. These measurements were used for descriptive purposed
only. In order to assess the anatomic relationship of the strip electrode to
both cortical structures and to the infarct, the pre-operative MRI (DWI) and T2
sequences were used. Image fusion was performed using automated software
(StealthStation S7, Medtronic: Minneapolis, MN) and validated with manual
review. DICOM measurement references were preserved in order to perform
subsequent distance measurements.

Carlson A.P., Davis H.T., Jones T., Brennan K.C., Torbey M., Ahmadian R., Qeadan F, & Shuttleworth C.W. (2022). Is the Human Touch Always Therapeutic? Patient Stimulation and Spreading Depolarization after Acute Neurological Injuries. Translational stroke research, 14(2), 160-173.

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Deep Brain Stimulation Targeting CM-Voi Complex

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The CM-Voi complex was targeted for stimulation with standard coordinates (midpoint AC/PC line coordinates: x= +/− 5 mm, y= −4 mm, z= 0 mm), adapted to the patient’s anatomy and with trajectory along the longest axis of Voi, based on preoperative magnetic resonance imaging (MRI) fused with stereotactic computed tomography (CT) scan with the atlas of the human brain (Schaltenbrand Atlas) overlaid (Cranial Software, version StealthStation™ S7, Medtronic, Minneapolis, MN, USA). Surgery was performed under analgosedation with intraoperative microelectrode recordings. All patients received quadripolar electrodes (Medtronic 3389) bilaterally, stereotactically guided. The accurate localization of the electrodes was confirmed via postsurgical CT scan. For optimal stimulation, the frequency, voltage and pulse width were individually adapted for best results.

Andrade P., Heiden P., Hoevels M., Schlamann M., Baldermann J.C., Huys D, & Visser-Vandewalle V. (2020). Modulation of Fibers to Motor Cortex during Thalamic DBS in Tourette Patients Correlates with Tic Reduction. Brain Sciences, 10(5), 302.

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Fiducial-Based MRI Registration Reliability

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We placed 5 self-adhesive fiducial markers on each participant before MRI (Fig. 1A). During IGS registration (StealthStation S7 surgical navigation system, Medtronic), we affixed a noninvasive electromagnetic reference tracker (AxiEM, Medtronic) to the forehead at a location above the left eyebrow at the midpupillary line. The participant was supine, with their head positioned neutral on a donut headrest. The surgeon performing registration was blinded to the scan sequence and performed standard surface matching by using points from roughly similar locations on all scans. The surgeon avoided the fiducial markers during surface mapping because the markers would later be used to evaluate registration (Fig. 1C). The surgeon repeated the registration process up to 3 times to evaluate the reliability of registration. The sequence was deemed unreliable if a sequence failed to register during at least 2 of these attempts.

Schnell M.J., Buonocore L., Kretzschmar E., Johnson E, & Rose J.K. (1996). Foreign glycoproteins expressed from recombinant vesicular stomatitis viruses are incorporated efficiently into virus particles.. Proceedings of the National Academy of Sciences of the United States of America, 93(21), 11359-11365.

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Neuronavigation Technique for Surgical Procedures

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Medtronic StealthStation S7 (Medtronic PLC, Minneapolis, MN, USA) was used for neuronavigation. Volumetric MRI scans were imported. Registration was performed using surface landmarks. Cartesian coordinates (x, y, z) were acquired and recorded for all registration points and assigned points in 3D space using the navigation probe. Each step of the surgical procedure included the acquisition of 3 to 8 different points corresponding to anatomical structures in the surgical field. For each point, screenshots of the navigation system were obtained verifying and illustrating the corresponding coordinates on axial, coronal, and sagittal planes as well as the 3D reconstructed image on the neuronavigation system (Figure 3B).

Hanalioglu S., Romo N.G., Mignucci-Jiménez G., Tunc O., Gurses M.E., Abramov I., Xu Y., Sahin B., Isikay I., Tatar I., Berker M., Lawton M.T, & Preul M.C. (2022). Development and Validation of a Novel Methodological Pipeline to Integrate Neuroimaging and Photogrammetry for Immersive 3D Cadaveric Neurosurgical Simulation. Frontiers in Surgery, 9, 878378.

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Correlating Glioma Infiltration with DOTATATE PET

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In three patients (#2, 3 and 15), ⁶⁸Ga-DOTATATE-PET/CT and MR images were transferred to a neuronavigation system (Stealth Station S7, Medtronic Navigation, Louisville, USA) and combined in image fusion planning (StealthMerge Image Registration, Medtronic Navigation, Louisville, USA). During surgery of the gliomas, neuronavigated biopsy specimens were separately obtained from areas with visually different ⁶⁸Ga-DOTATATE-uptake by an experienced neurosurgeon (M.L.) 3 samples out of areas with high, moderate and/or low ⁶⁸Ga-DOTATATE uptake were acquired from each patient and checked for macrophage infiltration. A total of nine samples (3 per patient) were examined. After histological processing, the percentage of microglia and macrophages was visually assessed, calculated and graded using the following scale: 0–20%, 20–50% and >50% related to the total number of cells assessed for SSTR2A staining. For each patient, 3 different tumor areas with a diameter of 5 to 10 mm were examined and correlated with the ⁶⁸Ga-DOTATATE uptake level (SUV_max).

Lapa C., Linsenmann T., Lückerath K., Samnick S., Herrmann K., Stoffer C., Ernestus R.I., Buck A.K., Löhr M, & Monoranu C.M. (2015). Tumor-Associated Macrophages in Glioblastoma Multiforme—A Suitable Target for Somatostatin Receptor-Based Imaging and Therapy?. PLoS ONE, 10(3), e0122269.

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Diffusion Imaging for Tumor Mapping

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Diffusion data were analyzed using commercial software (Brainlab iPlan® (Munich, Germany) or Medtronic StealthStation® S7 (Louisville, USA) using standard processes. Tracts were selected based on tumor location and included the arcuate/superior longitudinal fasciculus (SLF), inferior fronto-occipital fasciculus (IFOF), corticospinal tract (CST), optic radiations (OR) and inferior longitudinal fasciculus (ILF). Tractography plans were exported to the neuronavigation system (see Online Resource).

Voets N.L., Pretorius P., Birch M.D., Apostolopoulos V., Stacey R, & Plaha P. (2021). Diffusion tractography for awake craniotomy: accuracy and factors affecting specificity. Journal of Neuro-Oncology, 153(3), 547-557.

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