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Caliper navigation for craniotomy planning of convexity targets

Max Jägersberg, Michael Kosterhon, Florian Ringel
2021 PLoS ONE  
A technique to localize a radiological target on the head convexity fast and with acceptable precision is sufficient for surgeries of superficial intracranial lesions, and of help in the setting of emergency surgery, computer navigation breakdown, limited resources and education. We present a caliper technique based on fundamental geometry, with inexpensive and globally available tools (conventional CT or MRI image viewer, calculator, caliper). The distances of the radiological target from two
more » ... andmarks (nasion and porus acusticus externus) are assessed with an image viewer and Pythagoras' theorem. The two distances are then marked around the landmarks onto the head of the patient with help of a caliper. The intersection defines the target. We tested the technique in a saw bone skull model and afterwards in the operating room. Convexity targets were localized with the caliper navigation technique and then with computer navigation as ground truth. In the saw bone model, the mean offset between the caliper navigated target and the real target was 2.9 ± 2.8 mm, 95% CI (1.6 mm; 4.2 mm). The mean offset between computer navigated target and real target was 1.6 ± 0.9 mm, 95% CI (1.2 mm; 2 mm) (ns). In 15 patients undergoing navigated cranial procedures, 100 targets were assessed in reference to computer navigation. The mean offset of the caliper navigation was 11 ± 5.2 mm, 95% CI (9.9 mm; 12 mm). This is a low-tech approach for translation of a radiological target to the patient's head in short time and with globally available inexpensive tools, with satisfying precision for many procedures.
doi:10.1371/journal.pone.0251023 pmid:34014940 pmcid:PMC8136664 fatcat:32ho7sllavcrhce47du5ikd3ca

3D-Planung von Trajektorie und Objekt bei neurochirurgischen Wirbelsäuleneingriffen

Michael Kosterhon, Angelika Gutenberg, Eike S. Schwandt, Jens Conrad, Sven R. Kantelhardt, A. Nimer Amr, Joachim Gawehn, Alf Giese
2012 CURAC Jahrestagung  
Wir stellen eine neue Möglichkeit zur dreidimensionalen, präoperativen Planung vor, die nicht nur die Planung von minimalinvasiven Zugangswegen zur Wirbelsäule, sondern darüber hinaus auch eine 3D Modellierung von Instrumenten und die präoperative virtuelle Platzierung von realen Implantaten erlauben soll. Wir testeten diese Vorgehensweise erstmals im Rahmen des Débridement bei einer Patientin mit Spondylodiscitis.
dblp:conf/curac/KosterhonGSCKAG12 fatcat:5wxllcjyqffztfjita6xpgamfi

Bedeutung der 3D-OP-Planung und 3D-Navigation für die minimalinvasive Neurochirurgie

Eike S. Schwandt, Sven R. Kantelhardt, Ali Ayyad, Michael Kosterhon, Axel T. Stadie, Alf Giese
2012 CURAC Jahrestagung  
Seit 2004 wird zur dreidimensionalen OP-Planung in der Mainzer Neurochirurgie das Dextroscope-System genutzt, um neurochirurgische Eingriffe durch Optimierung der Zugangswege und Vorgehensweisen sicherer und schonender durchführen zu können. Hierzu werden zweidimensionale Schichtbildaufnahmen fusioniert. Weltweit werden mittlerweile in den Operationssälen nahezu jeder größeren neurochirurgischen Abteilung Navigationsgeräte eingesetzt, die dem Chirurgen intraoperativ die Orientierung
more » ... Auch diese Geräte verrechnen zweidimensionale Schichtbildaufnahmen und ermöglichen in diesen die Darstellung der exakten Position von OP-Instrumenten. Da es leider bislang nicht möglich war, die mit dem Dextroscope-System erstellten 3D-Planungsdaten zur intraoperativen Navigation zu nutzen, unternahmen wir nun erste Schritte, um mit präoperativ dreidimensional erstellten Planungsdaten intraoperativ dreidimensional navigieren zu können.
dblp:conf/curac/SchwandtKAKSG12 fatcat:6p6wb35xm5fyhkwv76op6d7g6y

Beyond Glioma: The Utility of Radiomic Analysis for Non-Glial Intracranial Tumors

Darius Kalasauskas, Michael Kosterhon, Naureen Keric, Oliver Korczynski, Andrea Kronfeld, Florian Ringel, Ahmed Othman, Marc A. Brockmann
2022 Cancers  
The field of radiomics is rapidly expanding and gaining a valuable role in neuro-oncology. The possibilities related to the use of radiomic analysis, such as distinguishing types of malignancies, predicting tumor grade, determining the presence of particular molecular markers, consistency, therapy response, and prognosis, can considerably influence decision-making in medicine in the near future. Even though the main focus of radiomic analyses has been on glial CNS tumors, studies on other
more » ... ranial tumors have shown encouraging results. Therefore, as the main focus of this review, we performed an analysis of publications on PubMed and Web of Science databases, focusing on radiomics in CNS metastases, lymphoma, meningioma, medulloblastoma, and pituitary tumors.
doi:10.3390/cancers14030836 pmid:35159103 pmcid:PMC8834271 fatcat:dlmy3vrajbegvfelkncu2z2oam

Correlation of cardiac function and cerebral perfusion in a murine model of subarachnoid hemorrhage

Axel Neulen, Michael Molitor, Michael Kosterhon, Tobias Pantel, Elisa Holzbach, Wolf-Stephan Rudi, Susanne H. Karbach, Philip Wenzel, Florian Ringel, Serge C. Thal
2021 Scientific Reports  
AbstractCerebral hypoperfusion is a key factor for determining the outcome after subarachnoid hemorrhage (SAH). A subset of SAH patients develop neurogenic stress cardiomyopathy (NSC), but it is unclear to what extent cerebral hypoperfusion is influenced by cardiac dysfunction after SAH. The aims of this study were to examine the association between cardiac function and cerebral perfusion in a murine model of SAH and to identify electrocardiographic and echocardiographic signs indicative of
more » ... We quantified cortical perfusion by laser SPECKLE contrast imaging, and myocardial function by serial high-frequency ultrasound imaging, for up to 7 days after experimental SAH induction in mice by endovascular filament perforation. Cortical perfusion decreased significantly whereas cardiac output and left ventricular ejection fraction increased significantly shortly post-SAH. Transient pathological ECG and echocardiographic abnormalities, indicating NSC (right bundle branch block, reduced left ventricular contractility), were observed up to 3 h post-SAH in a subset of model animals. Cerebral perfusion improved over time after SAH and correlated significantly with left ventricular end-diastolic volume at 3, 24, and 72 h. The murine SAH model is appropriate to experimentally investigate NSC. We conclude that in addition to cerebrovascular dysfunction, cardiac dysfunction may significantly influence cerebral perfusion, with LVEDV presenting a potential parameter for risk stratification.
doi:10.1038/s41598-021-82583-9 pmid:33558609 pmcid:PMC7870815 fatcat:gxrijtiarrgbrn4iar2ghud4yi

Load Distribution in the Lumbar Spine During Modeled Compression Depends on Lordosis

Andreas Müller, Robert Rockenfeller, Nicolas Damm, Michael Kosterhon, Sven R. Kantelhardt, Ameet K. Aiyangar, Karin Gruber
2021 Frontiers in Bioengineering and Biotechnology  
Excessive or incorrect loading of lumbar spinal structures is commonly assumed as one of the factors to accelerate degenerative processes, which may lead to lower back pain. Accordingly, the mechanics of the spine under medical conditions, such as scoliosis or spondylolisthesis, is well-investigated. Treatments via both conventional therapy and surgical methods alike aim at restoring a "healthy" (or at least pain-free) load distribution. Yet, surprisingly little is known about the inter-subject
more » ... variability of load bearings within a "healthy" lumbar spine. Hence, we utilized computer tomography data from 28 trauma-room patients, whose lumbar spines showed no visible sign of degeneration, to construct simplified multi-body simulation models. The subject-specific geometries, measured by the corresponding lumbar lordosis (LL) between the endplates of vertebra L1 and the sacrum, served as ceteris paribus condition in a standardized forward dynamic compression procedure. Further, the influence of stimulating muscles from the M. multifidus group was assessed. For the range of available LL from 28 to 66°, changes in compressive and shear forces, bending moments, as well as facet joint forces between adjacent vertebrae were calculated. While compressive forces tended to decrease with increasing LL, facet forces were tendentiously increasing. Shear forces decreased between more cranial vertebrae and increased between more caudal ones, while bending moments remained constant. Our results suggest that there exist significant, LL-dependent variations in the loading of "healthy" spinal structures, which should be considered when striving for individually appropriate therapeutic measures.
doi:10.3389/fbioe.2021.661258 pmid:34178959 pmcid:PMC8222614 fatcat:t5g6s72canc4hael6mygow4cd4

Neutrophils mediate early cerebral cortical hypoperfusion in a murine model of subarachnoid haemorrhage

Axel Neulen, Tobias Pantel, Michael Kosterhon, Andreas Kramer, Sascha Kunath, Maximilian Petermeyer, Bernd Moosmann, Johannes Lotz, Sven R. Kantelhardt, Florian Ringel, Serge C. Thal
2019 Scientific Reports  
Cerebral hypoperfusion in the first hours after subarachnoid haemorrhage (SAH) is a major determinant of poor neurological outcome. However, the underlying pathophysiology is only partly understood. Here we induced neutropenia in C57BL/6N mice by anti-Ly6G antibody injection, induced SAH by endovascular filament perforation, and analysed cerebral cortical perfusion with laser SPECKLE contrast imaging to investigate the role of neutrophils in mediating cerebral hypoperfusion during the first 24
more » ... post-SAH. SAH induction significantly increased the intracranial pressure (ICP), and significantly reduced the cerebral perfusion pressure (CPP). At 3 h after SAH, ICP had returned to baseline and CPP was similar between SAH and sham mice. However, in SAH mice with normal neutrophil counts cortical hypoperfusion persisted. Conversely, despite similar CPP, cortical perfusion was significantly higher at 3 h after SAH in mice with neutropenia. The levels of 8-iso-prostaglandin-F2α in the subarachnoid haematoma increased significantly at 3 h after SAH in animals with normal neutrophil counts indicating oxidative stress, which was not the case in neutropenic SAH animals. These results suggest that neutrophils are important mediators of cortical hypoperfusion and oxidative stress early after SAH. Targeting neutrophil function and neutrophil-induced oxidative stress could be a promising new approach to mitigate cerebral hypoperfusion early after SAH.
doi:10.1038/s41598-019-44906-9 pmid:31186479 pmcid:PMC6560094 fatcat:p7lwisfgfbaw5pmelhxqcf7roy

A segmentation-based volumetric approach to localize and quantify cerebral vasospasm based on tomographic imaging data

Axel Neulen, Tobias Pantel, Michael Kosterhon, Stefanie Kirschner, Marc A. Brockmann, Sven R. Kantelhardt, Alf Giese, Serge C. Thal, Nima Etminan
2017 PLoS ONE  
OPEN ACCESS Citation: Neulen A, Pantel T, Kosterhon M, Kirschner S, Brockmann MA, Kantelhardt SR, et al. (2017) A segmentation-based volumetric approach to localize and quantify cerebral vasospasm based  ... 
doi:10.1371/journal.pone.0172010 pmid:28199398 pmcid:PMC5310853 fatcat:mzo4elynv5d63o3yaeo6qtccq4

Muscle-driven and torque-driven centrodes during modeled flexion of individual lumbar spines are disparate

Robert Rockenfeller, Andreas Müller, Nicolas Damm, Michael Kosterhon, Sven R Kantelhardt, Rolfdieter Frank, Karin Gruber
2020 Biomechanics and Modeling in Mechanobiology  
Lumbar spine biomechanics during the forward-bending of the upper body (flexion) are well investigated by both in vivo and in vitro experiments. In both cases, the experimentally observed relative motion of vertebral bodies can be used to calculate the instantaneous center of rotation (ICR). The timely evolution of the ICR, the centrode, is widely utilized for validating computer models and is thought to serve as a criterion for distinguishing healthy and degenerative motion patterns. While in
more » ... ivo motion can be induced by physiological active structures (muscles), in vitro spinal segments have to be driven by external torque-applying equipment such as spine testers. It is implicitly assumed that muscle-driven and torque-driven centrodes are similar. Here, however, we show that centrodes qualitatively depend on the impetus. Distinction is achieved by introducing confidence regions (ellipses) that comprise centrodes of seven individual multi-body simulation models, performing flexion with and without preload. Muscle-driven centrodes were generally directed superior-anterior and tail-shaped, while torque-driven centrodes were located in a comparably narrow region close to the center of mass of the caudal vertebrae. We thus argue that centrodes resulting from different experimental conditions ought to be compared with caution. Finally, the applicability of our method regarding the analysis of clinical syndromes and the assessment of surgical methods is discussed.
doi:10.1007/s10237-020-01382-9 pmid:32939615 fatcat:tx3uk6flnngxlpoyabry57wyl4

Large Vessel Vasospasm Is Not Associated with Cerebral Cortical Hypoperfusion in a Murine Model of Subarachnoid Hemorrhage

Axel Neulen, Simon Meyer, Andreas Kramer, Tobias Pantel, Michael Kosterhon, Svenja Kunzelmann, Hermann Goetz, Serge C. Thal
2018 Translational Stroke Research  
Clinical studies on subarachnoid hemorrhage (SAH) have shown discrepancies between large vessel vasospasm, cerebral perfusion, and clinical outcome. We set out to analyze the contribution of large vessel vasospasm to impaired cerebral perfusion and neurological impairment in a murine model of SAH. SAH was induced in C57BL/6 mice by endovascular filament perforation. Vasospasm was analyzed with microcomputed tomography, cortical perfusion by laser SPECKLE contrast imaging, and functional
more » ... nt with a quantitative neuroscore. SAH animals developed large vessel vasospasm, as shown by significantly lower vessel volumes of a 2.5-mm segment of the left middle cerebral artery (MCA) (SAH 5.6 ± 0.6 nL, sham 8.3 ± 0.5 nL, p < 0.01). Induction of SAH significantly reduced cerebral perfusion of the corresponding left MCA territory compared to values before SAH, which only recovered partly (SAH vs. sham, 15 min 35.7 ± 3.1 vs. 101.4 ± 10.2%, p < 0.01; 3 h, 85.0 ± 8.6 vs. 121.9 ± 13.4, p < 0.05; 24 h, 75.3 ± 4.6 vs. 110.6 ± 11.4%, p < 0.01; 72 h, 81.8 ± 4.8 vs. 108.5 ± 14.5%, n.s.). MCA vessel volume did not correlate significantly with MCA perfusion after 72 h (r = 0.34, p = 0.25). Perfusion correlated moderately with neuroscore (24 h: r = − 0.58, p < 0.05; 72 h: r = − 0.44, p = 0.14). There was no significant correlation between vessel volume and neuroscore after 72 h (r = − 0.21, p = 0.50). In the murine SAH model, cerebral hypoperfusion occurs independently of large vessel vasospasm. Neurological outcome is associated with cortical hypoperfusion rather than large vessel vasospasm.
doi:10.1007/s12975-018-0647-6 pmid:30003500 fatcat:psxpljtzcveunbyqfumvxw665u

Automated Grading of Cerebral Vasospasm to Standardize Computed Tomography Angiography Examinations After Subarachnoid Hemorrhage

Axel Neulen, Svenja Kunzelmann, Michael Kosterhon, Tobias Pantel, Maximilian Stein, Manfred Berres, Florian Ringel, Marc A. Brockmann, Carolin Brockmann, Sven R. Kantelhardt
2020 Frontiers in Neurology  
Copyright © 2020 Neulen, Kunzelmann, Kosterhon, Pantel, Stein, Berres, Ringel, Brockmann, Brockmann and Kantelhardt.  ... 
doi:10.3389/fneur.2020.00013 pmid:32082241 pmcid:PMC7002561 fatcat:xxis5tsjffevhb4g5im2eqaefe

A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage

Axel Neulen, Michael Kosterhon, Tobias Pantel, Stefanie Kirschner, Hermann Goetz, Marc A. Brockmann, Sven R. Kantelhardt, Serge C. Thal
2018 Journal of Visualized Experiments  
Subarachnoid hemorrhage (SAH) is a subtype of hemorrhagic stroke. Cerebral vasospasm that occurs in the aftermath of the bleeding is an important factor determining patient outcome and is therefore frequently taken as a study endpoint. However, in small animal studies on SAH, quantification of cerebral vasospasm is a major challenge. Here, an ex vivo method is presented that allows quantification of volumes of entire vessel segments, which can be used as an objective measure to quantify
more » ... vasospasm. In a first step, endovascular casting of the cerebral vasculature is performed using a radiopaque casting agent. Then, cross-sectional imaging data are acquired by micro computed tomography. The final step involves 3-dimensional reconstruction of the virtual vascular tree, followed by an algorithm to calculate center lines and volumes of the selected vessel segments. The method resulted in a highly accurate virtual reconstruction of the cerebrovascular tree shown by a diameter-based comparison of anatomical samples with their virtual reconstructions. Compared with vessel diameters alone, the vessel volumes highlight the differences between vasospastic and non-vasospastic vessels shown in a series of SAH and sham-operated mice.
doi:10.3791/57997 pmid:30102288 pmcid:PMC6126573 fatcat:y25e4x3oe5f75mh64jxwijfrsa

Augmented Reality in Orthopedics: Current State and Future Directions

Dimitrios Chytas, Michael-Alexander Malahias, Vasileios S. Nikolaou
2019 Frontiers in Surgery  
Kosterhon et al. (47) reported the use of AR in a patient with congenital hemivertebra of the thoracolumbar spine, and the system was found useful for the surgeon during the resection of a complex-shaped  ...  Abe et al. (45) Spine surgery VIPAR The AR-based system offered a remarkable help to surgeons to find the ideal needle trajectory and insertion point when performing percutaneous vertebroplasty Kosterhon  ... 
doi:10.3389/fsurg.2019.00038 pmid:31316995 pmcid:PMC6610425 fatcat:teqq622shrg2dblvw3cidzbane


2022 Innovative Surgical Science  
Quantitative assessment and localization of the hollowing of the temple after craniectomy and cranioplasty -The frontozygomatic shadow ID: 605 Michael Kosterhon* 1 , Eva Ruegg 2 , Malte Ottenhausen 1 ,  ... 
doi:10.1515/iss-2022-2005 fatcat:rcrdth7nufgxpo433ogjq7howe

Page 339 of Institute of Petroleum (Great Britain). Journal of the Institute of Petroleum Vol. 39, Issue [page]

Institute of Petroleum (Great Britain). Journal of the Institute of Petroleum  
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