1. Modification of Laser Alignment of Cranial X-Rays Intraoperatively Pamela Tebebi Advisor: Peter Konrad, MD/PhD This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation In Slide Show, click on the right mouse button Select “Meeting Minder” Select the “Action Items” tab Type in action items as they come up Click OK to dismiss this box This will automatically create an Action Item slide at the end of your presentation with your points entered.

2. Project Goal Design an accurate sighting system by means of laser sighting alignment for the intraoperative X-ray taken of brain stimulator implants.

3. Problem Definition

4. Background of Deep Brain Stimulation (DBS) for Movement Disorders What is DBS? –A surgical procedure whereby electrodes are permanently implanted in particular parts of the brain and continuous stimulation administered by a small electric unit (generator) that is implanted under the skin of the chest –It is a way to control the abnormal activity of particular brain cells in the immediate vicinity of the stimulating electrode without destroying brain tissue How will this help movement problems –Goals of DBS are to improve the control of movement on the side opposite the stimulator –Depending on the type of movement disorder, this may result in loss of tremor, loss of rigidity, loss of dyskinesia or dystonia

5. Background continued Risk of DBS –Most serious is bleeding into the brain causing headache, paralysis, coma, or death –Infection (10%) –Malfunction of stimulator –Movement of the electrode

6. Significance of the Project Want to design an accurate sighting system by means of laser sighting alignment for the intraoperative X-ray taken of brain stimulator implants. True significance of taking an X-ray is to compare the stimulation site to the final site if implant so as to verify that the implant is still at the designated

7. Current DBS Device Developed by FHC, Inc (specialize in metal and glass microelectrode, needles and instrumentation for cellular research Does not allow for alignment of mT Platform is design from importing CT and MR scans into the mT Platform Planning Software which automatically designs a patient-customized adaptor to fiducial marker based stereotactic system that aligns the mT Platform Drive System to reach selected target microTargeting Platform System (mT Platform)

8. Proposed Methods to Align X- ray : Method 1 –Attaching on fiducial markers can be cumbersome and affect stability of mT Platform mT Platform Fiducial

9. Proposed Methods to Align X- ray : Method 2 mT Platform Location of fiducial Mounting Hub Positioner- aid in the path probe will travel to desired target Alignment device AC-PC line

10. Current Status Waiting to here from Ron Franklin, senior engineer at FHC to determine how adaptable the new method would be to their mT Platform System

11. Work Completed Research on other methods to align X-ray involve using mirror that can be rotated to hit desired target Other methods involve using a collimated laser beam to mimic x- ray beam path

12. Current Work Complete DesignSafe Analysis

13. Future Work Set up appointment with Ron Franklin to determine if anymore adaptations to the device are necessary