The Use of Intraoperative Radiography for Osteotomy Planning in Craniosynostosis Posterior Cranial Vault Distractor Application, Technique Description

Posterior cranial vault distraction osteogenesis (PVDO) is evolving as one of the first-line treatments in managing craniosynostosis. Intraoperative decision for sites of osteotomies requires precise planning and accurate placement of distractors. Objective: This technique helps in determining and confirming the pre-surgical planned osteotomy sites along with the distraction vectors. Technique: intraoperative plain skull radiography is used to determine the osteotomy site guiding placement of distractors using radio-opaque instrument. Result and discussion: we believe this technique helps translate the planned osteotomy sites and distraction vectors accurately to the skull and minimizes intra-operative error which will subsequently improve outcomes. Conclusion: This technique is a quick and safe tool for proper placement of posterior cranial vault distractor. However, further comparative studies are needed in addition to measuring cost, time added to the procedure, and radiation exposure.