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Evaluating Long Term Neurocognitive Outcomes Of Surgical Intervention For Sagittal Synostosis: Cranial Vault Remodeling Vs Spring Assisted Surgery
Kara Klomparens-Fisher, MD1, Eric Zeng, BS1, Mario Blondin, MD1, Daniel Couture, MD2, Lisa David, MD1, Christopher Runyan, MD, PhD1, Leah Chapman, PhD3.
1Wake Forest Department of Plastic and Reconstructive Surgery, Winston-Salem, NC, USA, 2Wake Forest Department of Neurosurgery, Winston-Salem, NC, USA, 3Wake Forest Department of Neuropsychology, Winston-Salem, NC, USA.

Purpose:
Previous studies indicated that patients with sagittal synostosis who underwent cranial vault remodeling (CVR) had higher intelligence than those receiving endoscopic surgery or spring-assisted surgery (SAS). However, geographic separation of study cohorts raises concerns about the validity of these findings. This study aims to compare neurocognitive outcomes in sagittal synostosis patients undergoing CVR or SAS, better controlling for demographic and geographic differences.
Methods:
We included patients from two North Carolina institutions who underwent CVR or SAS. We collected demographic data and assessed neurocognitive function using WASI-II, BRIEF-2, BASC-3, and NIH toolbox scores. Statistical analyses included two-sample t-tests or Wilcoxon Rank-Sum tests, alongside Analysis of Covariance to compare mean scores between groups, controlling for sex, age at surgery, education level, and ethnicity.
Results:
Patient demographics are outlined in Table 1. No significant differences were found in neurocognitive assessments, both with and without covariate adjustments (Figure 1, p =.126-.909). Significant correlations were noted between intelligence scores and mothers’ education levels (WASI-II p< .0001; NIH toolbox p< .001), consistent with neurocognitive literature for the general population.


Conclusion:
Contrary to earlier studies suggesting higher IQ in CVR patients, our findings indicate no significant differences in long-term neurocognitive outcomes between CVR and SAS.
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