Neuronavigation using an articulated arm with a bayonet probe on a computer graphic composite of magnetic resonance and computerized tomography images

This report describes a neurosurgical navigational system using a newly-designed articulated arm with an interchangeable probe shaped like a bayonet, which can be used in deep structures through narrow openings. This system enables three-dimensional integration of magnetic resonance and computed tomographical images, and thereby yields computer graphic composites of the scalp, brain, skull, and vessels. The arm was used in 15 patients during open brain surgery, including 5 skull base procedures. This system was useful for comprehension of skull base anatomy and could conveniently be used in microscopic neurosurgical procedures without limiting the operative field.