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[Materials for osteo-dural reconstruction in the cranium. An update]
B George1, P Jamet, P Frerebeau
1Service de Neurochirurgie, Hôpital Lariboisière, Paris.
Neuro-Chirurgie
|January 1, 1989
Summary
Neurosurgeons face challenges selecting cranial defect repair materials. Autologous bone grafts are preferred, while some synthetic implants show poor bone integration and water tightness.
Area of Science:
- Neurosurgery
- Biomaterials Science
- Craniofacial Reconstruction
Context:
- Cranial defects require biomaterials for bony or dural repair.
- Material selection involves balancing biocompatibility, biofunctionality, stability, and degradation.
- Ideal materials should be inert or biodegradable, sterilizable, disposable, easy to handle, and cost-effective.
Purpose:
- To review available materials for cranial defect repair.
- To assess the qualities and drawbacks of various biomaterials for neurosurgical applications.
- To report on the current practices and experiences of French neurosurgeons regarding these materials.
Summary:
- Materials for cranial repair include autologous grafts (iliac bone, pericranium) and heterologous bone, alongside synthetic implants (acrylic, ceramic, collagen-vicryl).
- Autologous grafts offer superior features, while irradiated heterologous bone requires stringent safety protocols.
- Many implants present drawbacks like high cost and insufficient biological properties, leading to decreased use of some, such as coral and B.O.P.
- French neurosurgeons predominantly use autologous bone grafts, acrylic for bone substitutes, and pericranium for dural repair.
- Emerging materials like polylactic acid and bovine pericardium are under investigation.
Impact:
- Informs neurosurgical material selection for cranial defect repair.
- Highlights the limitations of current synthetic implants and the need for improved biomaterials.
- Provides insights into clinical preferences and experiences, guiding future research and development in craniofacial reconstruction.