iMRI now available to infants
Until recently, intraoperative MRI (iMRI) has been unavailable to infants and patients with calvarium defects due to the need to pin the calvarium during surgical procedures. The surgical team at Le Bonheur recently published its findings using a new MRI-compatible horseshoe headrest by IMRIS in the Journal of Neurosurgery Pediatrics. The team found the Visius horseshoe headrest offered a technical advance in iMRI technology for infants, patients with cranial defects or prior craniotomies in whom pin fixation may not be safe or in whom the need to move the head during surgery is required.
The article provides two case studies – a 4-month-old infant for resection of a supratentorial tumor and a 2-yearold with a thin and pliable skull.
“The IMRIS horseshoe headrest worked well for providing the ideal prone positioning during this procedure,” said Frederick Boop, MD, chairman of the Department of Neurosurgery at the University of Tennessee Health Science Center, co-director of Le Bonheur’s Neuroscience Institute and Semmes-Murphey neurosurgeon. “In the past we would not have had an iMRI option for this child, and now the tumor is completely gone. We have now advanced our treatment to a group of kids for whom it will really make a difference. Even our youngest and most fragile patients can benefit from intraoperative MR, which would not have been possible otherwise.”
The device provides non-pinned (or non-rigid) head support in prone, lateral and supine positions during head, neck and cervical spine surgeries where use of a head fixation device (HFD) – a clamp-like device – is not desirable because the skull is too fragile for pinning. These patients may be babies whose skulls are still soft or older patients with weakened skull bones. This headrest may also be useful for other applications not requiring rigid fixation, such as those that access the skull through the nose.
Boop FA, Bate B, Choudhri AF, Burkholder B, Klimo P. Preliminary Experience with an Intra-operative MRI Compatible Infant Headholder: Technical Note. Journal of Neurosurgery Pediatrics published online Feb.13, 2015. DOI: 10.3171/2014.10.PEDS14447
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