Critical Analysis Of Spring Assisted Cranioplasty Outcomes In The Context Of Surgical Decision Making
Justin Beiriger, BSE, Rakan Saadoun, MD, John Smetona, MD, Michael Bykowski, MD, Joseph Losee, MD, Jesse Goldstein, MD.
UPMC, Pittsburgh, PA, USA.
PURPOSE:
This purpose of this study is to examine the correlation between surgeon-selected parameters (number of springs, spring force and maximum excursion width, age at surgery) and outcomes of spring-assisted cranioplasty. METHODS:
Patients with sagittal craniosynostosis who underwent spring-assisted cranioplasty for sagittal craniosynostosis from 2014-2021 were included. Clinical and radiographic data were collected. RESULTS:
Sixty-two patients met inclusion criteria. Forty-five were male (73%) and 3 were syndromic (5%). The average age was 4.54 ± 0.83 months. The average number of springs implanted was 2.4 ± 0.5, the average spring force was 7.4 ± 0.4 N, and the average excursion was 72.3 ± 4.0 mm. The operative time was 1.4 ± 0.3 hours, the EBL was 37.7 ± 36.2 mL, and the length of stay was 1.3 ± 0.6 days. The average preoperative CI was 69.6 ± 5.5, the average postoperative CI was 75.0 ± 4.7, and the percent change in CI from pre to post-op was 7.7 ± 9.7%. There were no statistically significant associations between age at surgery and change in CI (p=0.51), spring force and change in CI (p=0.78), spring excursion and change in CI (p=0.54), or number of springs and change in CI (p=0.20). CONCLUSION:
The change in CI from pre- to post-op was not affected by age at surgery, spring force or excursion, or number of springs. Despite the hypothesis that such parameters can be selected to increase or decrease the degree of head shape change, these modifiable factors do not seem to correlate with CI.
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