Turkish Neurosurgery 2024 , Vol 34 , Num 4
Factors Affecting Resorption Following Cranioplasty with an Autologous Bone Graft
Burak YURUK1,Ayhan TEKINER2,Yavuz ERDEM2,Haydar CELIK2,Mehmet Emre YILDIRIM2,Adem KURTULUS3,Omer SAHIN2,Koray OZTURK2,Tuncer TASCIOGLU2,Kemal KANTARCI4,Berkay AYHAN2,Zeliha CULCU GURCAN2,Huseyin Omer SEMIZ2,Mehmet Akif BAYAR2
1Nigde Research and Training Hospital, Department of Neurosurgery, Nigde, Türkiye
2Ankara Research and Training Hospital, Department of Neurosurgery, Ankara, Türkiye
3Duzce University, School of Medicine, Department of Neurosurgery, Duzce, Türkiye
4Hatay Research and Training Hospital, Department of Neurosurgery, Hatay, Türkiye
DOI : 10.5137/1019-5149.JTN.44249-23.2 AIM: To evaluate the relationship between the surgical techniques, the waiting time for surgery, postoperative distance between the graft-bone margin and the percentage of bone resorption, we analyzed patients who underwent cranioplasty. Cranioplasty is a necessary surgery to preserve brain tissue and provide an appropriate microenvironment.

MATERIAL and METHODS: In this study, patients who underwent autologous bone grafting after decompressive craniectomy by the Neurosurgery Clinic of University of Health Sciences 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: 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. Keywords : Decompressive craniectomy, Grafts, Cranium, Craniectomy, Resorption, Size

Corresponding author : Burak YURUK, burakyuruk26@gmail.com