Complication rates after autologous cranioplasty following decompressive craniectomy.
Humans
Decompressive Craniectomy
/ adverse effects
Male
Middle Aged
Female
Adult
Retrospective Studies
Postoperative Complications
/ epidemiology
Bone Transplantation
/ adverse effects
Reoperation
/ statistics & numerical data
Transplantation, Autologous
/ adverse effects
Plastic Surgery Procedures
/ methods
Aged
Skull
/ surgery
Risk Factors
Autologous cranioplasty
Bone flap resorption
Complications
Cranial defect
Decompressive craniectomy
Infection
Risk factors
Skull reconstruction
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
25 Sep 2024
25 Sep 2024
Historique:
received:
01
07
2024
accepted:
20
09
2024
medline:
25
9
2024
pubmed:
25
9
2024
entrez:
25
9
2024
Statut:
epublish
Résumé
The reimplantation of autologous bone grafts after decompressive craniectomy (DC) is still up for debate. The objective of this study was to analyze the surgical revision rate for autologous cranioplasties in our center, aiming to identify predictors for procedure-related-complications. A retrospective single-center study was conducted for adult patients who underwent autologous cranioplasty after DC. The primary endpoint was the complication rate in terms of surgical revision and removal of the bone graft: infection, new onset seizures, dislocation, haemorrhage, osteolysis, wound dehiscence and cerebrospinal fluid (CSF) fistula. Demographic data, medical records, surgical reports and imaging studies were analysed and risk factors for complications were evaluated. 169 consecutive patients were included. The median interval between DC and cranioplasty was 84 days. Mean age was 51 ± 12.4 years. 26 patients (15.3%) had revision surgery for following reasons. n = 9 implant dislocations (5.3%), n = 7 osteolysis (3.6%), n = 6 infections (3.6%), n = 5 had re-bleedings (3%), n = 5 wound dehiscences (3%), and n = 2 CSF fistulas (1.2%). 18 patients developed new seizures (10.7%). Bi- and multivariate analysis revealed three independent risk factors, simultaneous ventriculo-peritoneal (VP) shunting increased the risk for material dislocation (p < 0.001); large bone grafts (> 193.5 cm The complication rates in our study were comparable to previously reported data for autologous or artificial cranioplasties. As osteolysis was correlated to larger bone grafts, a synthetic alternative should be considered in selected cases.
Identifiants
pubmed: 39320557
doi: 10.1007/s00701-024-06282-w
pii: 10.1007/s00701-024-06282-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
380Informations de copyright
© 2024. The Author(s).
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