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Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients
Cranioplasty (CP) is a standard procedure in neurosurgical practice for patients after (decompressive) craniectomy. However, CP surgery is not standardized, is carried out in different ways, and is associated with considerable complication rates. Here, we report our experiences with the use of diffe...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121727/ https://www.ncbi.nlm.nih.gov/pubmed/32844249 http://dx.doi.org/10.1007/s10143-020-01374-4 |
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author | Giese, Henrik Meyer, Jennifer Unterberg, Andreas Beynon, Christopher |
author_facet | Giese, Henrik Meyer, Jennifer Unterberg, Andreas Beynon, Christopher |
author_sort | Giese, Henrik |
collection | PubMed |
description | Cranioplasty (CP) is a standard procedure in neurosurgical practice for patients after (decompressive) craniectomy. However, CP surgery is not standardized, is carried out in different ways, and is associated with considerable complication rates. Here, we report our experiences with the use of different CP materials and analyze long-term complications and implant survival rates. We retrospectively studied patients who underwent CP surgery at our institution between 2004 and 2014. Binary logistic regression analysis was performed in order to identify risk factors for the development of complications. Kaplan-Meier analysis was used to estimate implant survival rates. A total of 392 patients (182 females, 210 males) with a mean age of 48 years were included. These patients underwent a total of 508 CP surgeries. The overall complication rate of primary CP was 33.2%, due to bone resorption/loosening (14.6%) and graft infection (7.9%) with a mean implant survival of 120 ± 5 months. Binary logistic regression analysis showed that young age (< 30 years) (p = 0.026, OR 3.150), the presence of multidrug-resistant bacteria (p = 0.045, OR 2.273), and cerebrospinal fluid (CSF) shunt (p = 0.001, OR 3.137) were risk factors for postoperative complications. The use of titanium miniplates for CP fixation was associated with reduced complication rates and bone flap osteolysis as well as longer implant survival rates. The present study highlights the risk profile of CP surgery. Young age (< 30 years) and shunt-dependent hydrocephalus are associated with postoperative complications especially due to bone flap autolysis. Furthermore, a rigid CP fixation seems to play a crucial role in reducing complication rates. |
format | Online Article Text |
id | pubmed-8121727 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-81217272021-05-18 Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients Giese, Henrik Meyer, Jennifer Unterberg, Andreas Beynon, Christopher Neurosurg Rev Original Article Cranioplasty (CP) is a standard procedure in neurosurgical practice for patients after (decompressive) craniectomy. However, CP surgery is not standardized, is carried out in different ways, and is associated with considerable complication rates. Here, we report our experiences with the use of different CP materials and analyze long-term complications and implant survival rates. We retrospectively studied patients who underwent CP surgery at our institution between 2004 and 2014. Binary logistic regression analysis was performed in order to identify risk factors for the development of complications. Kaplan-Meier analysis was used to estimate implant survival rates. A total of 392 patients (182 females, 210 males) with a mean age of 48 years were included. These patients underwent a total of 508 CP surgeries. The overall complication rate of primary CP was 33.2%, due to bone resorption/loosening (14.6%) and graft infection (7.9%) with a mean implant survival of 120 ± 5 months. Binary logistic regression analysis showed that young age (< 30 years) (p = 0.026, OR 3.150), the presence of multidrug-resistant bacteria (p = 0.045, OR 2.273), and cerebrospinal fluid (CSF) shunt (p = 0.001, OR 3.137) were risk factors for postoperative complications. The use of titanium miniplates for CP fixation was associated with reduced complication rates and bone flap osteolysis as well as longer implant survival rates. The present study highlights the risk profile of CP surgery. Young age (< 30 years) and shunt-dependent hydrocephalus are associated with postoperative complications especially due to bone flap autolysis. Furthermore, a rigid CP fixation seems to play a crucial role in reducing complication rates. Springer Berlin Heidelberg 2020-08-26 2021 /pmc/articles/PMC8121727/ /pubmed/32844249 http://dx.doi.org/10.1007/s10143-020-01374-4 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Giese, Henrik Meyer, Jennifer Unterberg, Andreas Beynon, Christopher Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients |
title | Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients |
title_full | Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients |
title_fullStr | Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients |
title_full_unstemmed | Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients |
title_short | Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients |
title_sort | long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121727/ https://www.ncbi.nlm.nih.gov/pubmed/32844249 http://dx.doi.org/10.1007/s10143-020-01374-4 |
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