Prone Positioning in the Leksell G Frame for Posterior Fossa Stereotaxy in Young Children

Kirchleitner, Sabrina V. (2026): Prone Positioning in the Leksell G Frame for Posterior Fossa Stereotaxy in Young Children. World Neurosurgery, 208: 124870. ISSN 1878-8750

Abstract

Background

Stereotactic interventions in the posterior fossa of children are rarely performed due to anatomical constraints, technical limitations, and lack of dedicated studies. Traditional stereotactic methods, including upside-down frame placement or intraoperative repositioning, present challenges such as increased procedural complexity, risk of pin dislodgement, and the need for manual coordinate calculations. This study evaluates a novel technique using prone positioning in the Leksell G frame for posterior fossa stereotactic procedures in pediatric patients. By modifying standard intraoperative workflows, this method allows for safe, precise, and cost-effective stereotactic interventions without additional hardware.

Methods

A retrospective analysis was conducted on 6 stereotactic procedures in 3 pediatric patients (ages 19 months–8.6 years, median 2.79 years) treated using the Leksell G frame in prone position. The approach involved adjusting computed tomography scan orientation to maintain compatibility with Brainlab iPlan software.

Results

By positioning the patient in the final surgical alignment before computed tomography acquisition, unnecessary repositioning was avoided, reducing risks of frame instability and pin-related complications. Additional padding for stability and rotating the head within the frame secured optimal access. All procedures were technically successful, with accurate targeting confirmed postoperative.

Conclusions

Prone positioning in the Leksell G frame, with specific technical modifications, enables safe and accurate stereotactic posterior fossa procedures in pediatric patients. This approach eliminates the need for intraoperative repositioning and ensures seamless integration with widely available stereotactic planning software. By utilizing existing tools and refining workflow, this method provides a practical, cost-effective, and reproducible solution for extending stereotactic neurosurgery to the pediatric population.

• Dokumententyp: Artikel (Klinikum der LMU)
• Organisationseinheit (Fakultäten): 07 Medizin > Klinikum der LMU München > Neurochirurgische Klinik und Poliklinik
• DFG-Fachsystematik der Wissenschaftsbereiche: Lebenswissenschaften
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 491502892