Stereotaxis

Definition: What Is Stereotaxis?

Stereotaxis describes minimally invasive treatment methods in medicine that use image-guided and computer-assisted targeting systems to precisely control the patient's position with the therapy device, so that exact radiation or surgery can be carried out. Stereotactic neurosurgery is used to diagnose disease foci located deep in the skull and treat brain tumors and vascular malformations. It is also used in the treatment of movement disorders and certain forms of chronic pain.

Which Medical Procedures Are Included in Stereotaxis?

Stereotaxis circumscribes the following procedures:

• Stereotactic neurosurgery: oncological stereotaxis, functional stereotaxis.

• Stereotactic radiotherapy

In principle, there are the following radiation options for stereotactic radiotherapy procedures, which differ in the number of individual doses per session:

• Normo-fractionated stereotaxis (e.g., 25-33 sessions, 4-5 x / week).

• Hypo-fractionated stereotaxis (e.g. 7-10 sessions, 2-3 x / week).

• Single time irradiation / radiosurgery (only 1 session)

Stereotactic Neurosurgery

Stereotactic brain surgery is a minimally invasive procedure in neurosurgery and radio-oncology in which the procedure is carried out while the patient's head is fixed. Today's stereotactic procedures often use real-time imaging by computed tomography (CT) and magnetic resonance imaging (MRI), as well as computer-assisted instrument guidance. This means that images of the patient's anatomy and position are continuously taken during the procedure to ensure the correct localization of the treatment instruments. Furthermore, the image-guided, computer-assisted calculation of the paths and distances of the therapeutic devices allows the experienced physician to move safely within the body. Among others, this is used to puncture or remove deeper cancerous tissue. In addition, vascular malformations can be targeted and treated. These interventions are summarized in oncological stereotaxis. On the other hand, functional stereotaxis involves the treatment of movement disorders such as tremors and chronic pain.

Stereotactic Radiotherapy

In radiotherapy, stereotactic radiotherapy means that a tumor is irradiated with small volume and precision. The target volume of irradiation should be 0.5-4 cm in diameter. As a result, the surrounding healthy tissue is hardly exposed to radiation and thus spared. Since the ray always crosses in the tumor coming from many different directions, a high dose arrives. In contrast, a significantly lower dose arrives only a few millimeters next to it.

Which Doctors and Clinics Are Specialized in Stereotaxis?

Specialists in stereotactic radiotherapy are physicians specializing in radiotherapy and radiation oncology. They work closely in clinics of the same name with medical physicists, who play a key role in planning the radiation treatment. Specialists in stereotactic brain surgery are neurosurgeons. They work in neurosurgery clinics, most of which are part of university hospitals.

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Sources:

Wannemacher et al. (Hrsg.): Strahlentherapie . 2. Auflage. Springer 2013, ISBN 3-540-88304-5.

Piper: Innere Medizin . 2. Auflage. Springer 2012, ISBN 978-3-642-33107-7.