CLINICAL RESEARCH

Synaptive Medical is dedicated to engaging our partners by supporting evidence-based studies that demonstrate the value of our BrightMatter™ solutions to hospitals and surgeons, which ultimately helps improve patient care.

PEER REVIEWED ARTICLES

BrightMatter Servo offers a viable alternative to the Surgical Microscope in spinal procedures

BrightMatter Servo offers a viable alternative to the Surgical Microscope in spinal procedures

Dr Jens Chapman and his colleagues at Swedish Neuroscience Institute, Seattle WA, presented a study comparing operative microscope (OM) and BrightMatter Servo on a population of residents and fellows in a cadaveric spinal dissection model. BrightMatter Servo was found to be comparable against the OM in procedure time and the quality of the dissection and the rate of complication. However, BrightMatter Servo offered advantages such as ergonomics, ease of use, teaching potential, and higher depth of field. In conclusion, BrightMatter Servo offers a viable alternative to the OM in a spinal cadaveric setting without sacrificing on the quality and time of the procedure.1

BrightMatter Solution Case Report: White matter tract recovery following medial temporal lobectomy and selective amygdalohippocampectomy for astrocytoma and seizure focus resection

BrightMatter Solution Case Report: White matter tract recovery following medial temporal lobectomy and selective amygdalohippocampectomy for astrocytoma and seizure focus resection

Dr Amin Kassam at Aurora St Luke’s Medical Centre, Milwaukee WI, presented a case report illustrating the use of the BrightMatter™ solution. Patient had seizures and a mesial temporal lobe astrocytoma that forced the inferior longitudinal fasciculus (ILF) to deviate laterally and diminished the fractional anisotropy of the uncinate fasciculus (UF) when visualized by BrightMatter™ Plan. An awake medial temporal lobectomy and selective amygdalohippocampectomy was performed where BrightMatter™ Servo’s video microscope aided in tissue differentiation and surgical resection. The patient was seizure free with no post-operative complications. Post-operative DTI with BrightMatter™ Plan revealed preservation and restoration of the inferior-fronto-occipital fasciculus, ILF, and UF.2

Visualization of white matter tractography with BrightMatter Plan aids in minimally invasive surgical planning of deep-seated intraventricular and periventricular lesions.

Visualization of white matter tractography with BrightMatter Plan aids in minimally invasive surgical planning of deep-seated intraventricular and periventricular lesions.

A multi-center study led by Dr Julian Bailes at NorthShore University Health System, Evanston IL, performed a retrospective study of 20 patients describing the experience of presurgical planning with white matter tractography for the purposes of minimally invasive approaches. Two representative cases of a metastatic tumor and a high-grade glioma demonstrated the use of BrightMatter™ Plan to identify a minimally invasive surgical approach to maximally preserve the white matter tracts. Both patients showed a lack of post-operative deficits. 3

Training Medical Novices in Spinal Microsurgery: Does the Modality Matter?

Training Medical Novices in Spinal Microsurgery: Does the Modality Matter?

Dr Rod Oskouian and his colleagues from Swedish Neuroscience Institute, Seattle WA, studied medically naïve individuals and compared the use of BrightMatter Servo and the surgical microscope in a cadaveric setting performing a lumbar laminotomy. The study found that there was a strong preference towards BrightMatter Servo in ergonomics, ease of use, and its potential as a training module.

Case Studies

Ependymoma

Ependymoma

Ian Lee, MD, FAANS, Neurosurgeon, Henry Ford Health System

Whole Brain Tractography visualization by BrightMatter™ Plan provided critical information of the relationship between the Ependymoma in relation to the cortical spinal tract (CST) that was not present in standard MRI. This additional information informed the surgeon of the brain tumor margins which minimized loss of motor function during tumor resection. Intraoperative cortical stimulation mapping confirmed the location of the CST generated by BrightMatter™ Plan.

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Intracerabral Hematoma

Intracerabral Hematoma

Lloyd Zucker, MD, FAANS, Chief of Neurosurgery, Delray Medical Center

Whole Brain Tractography visualization by BrightMatter™ Plan identified a corridor for surgical evacuation of an ICH. This changed the treatment management for the patient from a watchful waiting approach to a surgical evacuation approach. Post-operative DTI visualized by BrightMatter™ Plan showed evidence of tract recovery with minimal evidence of the surgical approach.

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High Grade Glioma

High Grade Glioma

Gustavo Pradilla, MD, Chief of Neurosurgery, Grady Memorial Hospital

Whole brain tractography visualization by BrightMatter™ Plan provided new information about the relationship of the tumor and its surrounding tractography. It was found that the intended surgical approach (without tractography information) would have put critical white matter fibers at risk. Therefore, BrightMatter™ Plan changed the intended surgical approach into one that was minimally invasive with respect to white matter preservation.

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Glioblastoma Multiforme

Glioblastoma Multiforme

Gustavo Pradilla, MD, Chief of Neurosurgery, Grady Memorial

Whole brain tractography visualization by BrightMatter™ Plan revealed that the pathology displaced surrounding white matter tracts and suggested that surgical debulking could improve the functional status of the patient in preparation for adjuvant chemoradiation. This new information provided by BrightMatter™ Plan prompted a change in disease management from an initial biopsy to a surgical debulking.

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  1. Reprinted from World Neurosurgery, Vol 98, Marc D. Moisi, Kimberly Hoang, R. Shane Tubbs, Jeni Page, Christian Fisahn, David Paulson, Shiveindra Jeyamohan, Johnny Delashaw, David Hanscom, Rod J. Oskouian, Jens Chapman, Advancement of Surgical Visualization Methods: A Comparison Study between Traditional Microscopic Surgery and a Novel Robotic Optoelectronic Visualization Tool for Spinal Surgery, Pages 273-277, Copyright 2016, with permission from Elsevier.
  2. Image reprinted from World Neurosurgery, Vol 90, Javed Khader Eliyas, Ryan Glynn, Charles G. Kulwin, Richard Rovin, Ronald Young, Juan Alzate, Gustavo Pradilla, Mitesh V. Shah, Amin Kassam, Ivan Ciric, Julian Bailes, Minimally Invasive Transsulcal Resection of Intraventricular and Periventricular Lesions Through a Tubular Retractor System: Multicentric Experience and Results, Pages 556-564, Copyright 2016, with permission from Elsevier.
  3. Reprinted from Interdisciplinary Neurosurgery, Vol 6, Srikant S. Chakravarthi, Anthony Zbacnik, Jonathan Jennings, Melanie B. Fukui, Nathaniel Kojis, Richard A. Rovin, Amin B. Kassam, White matter tract recovery following medial temporal lobectomy and selective amygdalohippocampectomy for tumor resection via a ROVOT-m port-guided technique: A case report and review of literature, Pages 55-61, Copyright 2016, with permission from Elsevier.