Cranial Reconstruction Using Autologous Bone and Methylmethacrilate

Novaković, Nenad; Malivuković, Ana; Minić, L; Lepić, Milan; Mandić‐Rajčević, Stefan; Rasulić, Lukas

doi:10.1097/scs.0000000000003499

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…However, when the infection rates were compared based on CP size, the infection rates were 2% for bone and 13.9% for PMMA with skull defects >70 cm 2 , which was significantly different, but in defects <70 cm 2 , there was no significant difference in infection rates indicating graft material has a greater impact on large skull defects, in which case PMMA may be contraindicated. 7 Other results found no significant difference in infection rates between PMMA and AB for all CP patients, as well as the subset of patients with TBI. 20,50 When considering the risks and benefits associated with autografts versus HA implants, both autografts and HA prosthetics have osteogenic potential promoting their integration with the surrounding bone.…”

Section: Comparisons To Consider When Choosing a Cranial Graft Materialsmentioning

confidence: 87%

“…1,4 Infection and graft resorption are the most common complications associated with CP. [5][6][7] The cause of the high complication rates with CP is complex and multifactorial with both patient-and surgery-specific factors contributing to varying extents in different cases. The graft material used for CP is a potential factor contributing to the variance in complication rates, but data in the literature regarding the influence of graft material on post-CP outcomes are inconsistent making it difficult to determine if, when, and to what extent the choice of graft material impacts the rate of perioperative complications.…”

Section: Introductionmentioning

confidence: 99%

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The Materials Utilized in Cranial Reconstruction: Past, Current, and Future

et al. 2020

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Background: Cranioplasty (CP) is associated with high complication rates compared to other common neurosurgical procedures. Several graft materials are used for CP, which may contribute to the high complication rates, but data in the literature regarding the influence of graft material on post-CP outcomes are inconsistent making it difficult to determine if, when, and to what extent the graft material impacts the rate of perioperative complications. There is an increased demand to identify and develop superior graft materials. Objective: To review and compare the indications, risks, complications, and patient results associated with the use of different graft materials for cranial reconstructions. Design: A search through EBSCO host was conducted using the keywords “craniectomy” or “decompressive craniectomy,” “cranioplasty,” and “materials.” The search was limited to literature published in the English language from 2005 until the present. Ultimately, 69 articles were included in this review. Due to the heterogeneity of the study populations, results, statistical analyses, and collecting methods, no statistical analyses could be performed. Conclusions: Several graft materials have been adapted for use in cranial reconstructions with inconsistent results making it unclear if or when one material may be indicated over others. Advances in computer-aided design have led to improved patient-specific implants, but the ideal graft material is still being sought after in ongoing research efforts. Reviewing materials currently available, as well as those in clinical trials, is important to identify the limitations associated with different implants and to guide future research.

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Section: Comparisons To Consider When Choosing a Cranial Graft Materialsmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

The Materials Utilized in Cranial Reconstruction: Past, Current, and Future

et al. 2020

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“… 8 9 Cranial reconstructive surgery done using MMA has higher rates of infection and wound-healing disorders. 10 11 Study of the long-term consequences of MMA usage for cranioplasty found a 23% complication rate within 8 years of operation. 12 Another study demonstrated that MMA has a high infection rate of 12.7% compared with other materials and is similar to autologous flaps.…”

Section: Introductionmentioning

confidence: 99%

Frontotemporal Craniotomy for Clipping of Unruptured Aneurysm Using a Diamond-Coated Thread Wire Saw and Reconstruction Using Calcium Phosphate Cement without Metal Fixation

et al. 2023

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Metal fixation systems for cranial bone flaps cut by a drill are convenient devices for cranioplasty, but cause several complications. We use modified craniotomy using a fine diamond-coated threadwire saw (diamond T-saw) to reduce the bone defect, and osteoplasty calcium phosphate cement without metal fixation. We report our outcomes and tips of this method. A total of 78 consecutive patients underwent elective frontotemporal craniotomy for clipping of unruptured intracranial aneurysms between 2015 and 2019. The follow-up periods ranged from 13 to 66 months. The bone fixation state was evaluated by bone computed tomography (CT) and three-dimensional CT (3D-CT). The diamond T-saw could minimize the bone defect. Only one wound infection occurred within 1 week postoperatively, and no late infection. No pain, palpable/cosmetically noticeable displacement of the bone flap, fluid accumulations, or other complications were observed. The condition of bone fixation and the cosmetic efficacy were thoroughly satisfactory for all patients, and bone CT and 3D-CT demonstrated that good bone fusion. No complication typical of metal fixation occurred. Our method is technically easy and safety, and achieved good mid-term bone flap fixation in the mid-term course, so has potential for bone fixation without the use of metal plates.

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