Turkish Neurosurgery
FACTORS AFFECTING RESORPTION FOLLOWING CRANIOPLASTY WITH AN AUTOLOGOUS BONE GRAFT
Burak Yürük1, Ayhan Tekiner2, Yavuz Erdem2, Haydar Çelik2, Mehmet Emre Yıldırım2, Adem Kurtuluş3, Ömer Şahin2, Koray Öztürk2, Tuncer Taşcıoğlu2, Kemal Kantarcı4, Berkay Ayhan2, Zeliha Çulcu Gürcan2, Hüseyin Ömer Semiz2, Mehmet Akif Bayar2
1Niğde Research and Training Hospital, Neurosurgery, Niğde,
2Ankara Research and Training Hospital, Neurosurgery, Ankara,
3University of School of Medicine, Neurosurgery, Düzce,
4Hatay Research and Training Hospital, Neurosurgery, Hatay,
DOI: 10.5137/1019-5149.JTN.44249-23.2
Aim:Aim: Cranioplasty surgery is a necessary surgical procedure in patients who have undergone decompressive craniectomy surgery to preserve brain tissue and provide an appropriate microenvironment. The traditional and most commonly used method is an autologous bone graft with repositioning of the native bone flap. In this study, we aimed to evaluate the relationship between the surgical technique used in autologous cranioplasty, the waiting time for cranioplasty, the distance between the graft-bone margin after cranioplasty and the percentage of bone resorption. Material and Methods:In this study, patients who underwent autologous bone grafting after decompressive craniectomy by the Neurosurgery Clinic of SBU Ankara Training and Research Hospital between 2018 and 2021 were examined.Results:Thirty-nine patients who underwent autologous cranioplasty following decompressive craniectomy were included in the study. The average expected time for cranioplasty surgery following decompressive craniectomy was 16.97±13.478 weeks (min:2 max:62 weeks). The expected time between decompressive craniectomy and cranioplasty surgeries and resorption rates were compared. The resorption rate was above 30% in 7 of 10 patients with 24 weeks or more between craniectomy and cranioplasty, and less than 30% in 17 of 25 patients in surgeries less than 24 weeks (p=0.04). Following cranioplasty surgery, the distance between the graft-bone margin and the resorption rates were also compared. In this analysis, statistically significant differences were detected between the distance between the graft-bone border and the resorption rates. Resorption rates increased in 15 of 19 patients with a postcranioplasty distance of 1 mm or more (p<0.00001). Conclusion:In conclusion, early cranioplasty surgery is important in order to reduce complications that may occur after craniectomy. In addition, it is important to keep the defect area small in size during craniectomy surgery and to keep the cutting edge thinner when the bone graft is taken, in order to reduce the development of bone graft resorption.
Corresponding author : Burak Yürük