PR02 *SPRING‐ASSISTED CRANIOPLASTY – RESULTS OF CHRONOLOGICAL CHANGES TO SKULL DIMENSIONS

Abstract

Purpose: To demonstrate chronological changes of spring expansion in the treatment of scaphocephaly and brachycephaly. Spring‐assisted cranioplasty has become the first‐line treatment option for patients less than one year‐old with scaphocephaly and in some cases with brachycephaly. The speed of spring expansion and its in‐situ expansile behaviour has not been previously demonstrated in humans.Methodology: From January 2008 to December 2008, five patients underwent spring‐assisted Cranioplasty (4 scaphocephaly, 1 brachycephaly). The cephalic index, head circumference was measured chronologically until 3‐month postoperatively. Postoperative intracranial volume was calculated in one centre with post‐spring removal head CT. Prospective review of patient's operative time and blood loss, hospital time, changes in cephalic index (CI) and intracranial volume.Results: The average age of the patients were 5.2 months, operative time was averaged 70 minutes, operative blood loss was less than 50 ml, however three of five cases required blood transfusion day 1 postoperatively. Average hospital stay was 3 days, the preoperative CI was 70% for scaphocephalic patients and 83% for the brachycephalic patient. The 3‐month postoperative CI was 76% and 79%, respectively, the changes in intracranial volume was 356 ml.Conclusion: 30% of its total expansion occurs during the operation. The remaining spring's expansion capacity takes place in the first postoperative month as the skull lengthening occurs. Spring‐assisted cranioplasty is useful in increasing intracranial volume in patients with craniocerebral disproportion and high risk of developing increased intracranial pressure.