Related Experiment Videos
Application of osteoinductive calcium phosphate ceramics in children's endoscopic neurosurgery: report of five cases
Jia Wei1, Hufei Qian1, Yu Liu1
1Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China and.
Insights
Osteoinductive calcium phosphate (CaP) ceramics effectively closed drilled skull holes in pediatric neurosurgery patients. This biomaterial also prevented cerebrospinal fluid (CSF) leakage and promoted bone regeneration, showing promising clinical potential.
Area of Science:
- Biomaterials Science
- Neurosurgery
- Pediatric Orthopedics
Background:
- Drilled skull holes in pediatric endoscopic neurosurgery can lead to cerebrospinal fluid (CSF) leakage.
- Effective closure of these defects is crucial for patient recovery and preventing complications.
Purpose of the Study:
- To investigate the efficacy of osteoinductive calcium phosphate (CaP) ceramics in closing drilled skull holes.
- To assess the potential of CaP ceramics to prevent postoperative CSF leakage in children.
- To evaluate the bone regeneration capacity of CaP ceramics in a pediatric neurosurgical context.
Main Methods:
- Five pediatric patients (3-8 years old) underwent endoscopic neurosurgery with CaP ceramic-filled skull holes.
- Postoperative follow-up included CT scans at multiple time points (1 day to 6 months).
- Bone regeneration was further assessed in a monkey model using micro-CT and histological analysis.
Main Results:
- All five pediatric cases showed successful closure of drilled skull holes with CaP ceramics.
- No instances of CSF leakage or implant rejection were observed during follow-up.
- CT scans revealed progressive healing of the drilled holes, with significant bone regeneration evident by 6 months.
- Animal model studies confirmed CaP's osteoinductive properties, with newly formed bone density reaching 65.7%.
Conclusions:
- Osteoinductive CaP ceramics are a viable and effective material for treating drilled skull holes in pediatric endoscopic neurosurgery.
- CaP ceramics demonstrate potential in preventing CSF leakage and promoting bone defect repair.
- Further clinical studies with larger cohorts and extended follow-up are warranted to fully establish long-term clinical outcomes.
Abstract:
This work aimed at investigating the possibility and effectiveness of osteoinductive calcium phosphate (CaP) ceramics to close the drilled skull holes and prevent the postoperative cerebrospinal fluid (CSF) leaking in children's endoscopic neurosurgery. Five children patients (four boys and one girl, 3- to 8-years old) underwent the surgery, in which the endoscopic third ventriculostomy (ETV) was operated in four cases of hydrocephalus, and biopsy and ETV were both performed in one case of pineal tumor. The drilled skull holes were filled with the commercial osteoinductive CaP ceramics. The patients were followed up by CT scan at 1, 7 days, 3 and 6 months postoperatively. All the five cases were successful, and the holes were closed well after filled with the ceramics. The follow-up survey showed that no CSF leaking or rejection reaction was found. The CT scan indicated that the drilled holes began healing at 7 days postoperatively, and a relatively complete healing happened at 6 months postoperatively. The excellent ability of the CaP ceramics to induce bone regeneration was also confirmed by repairing the skull defects in a monkey model. The results of μ-CT and histological analysis showed that a bony structure with irregular array occurred at the defect area, and the newly formed bone volume density reached 65.7%. In conclusion, the osteoinductive CaP ceramics could be an ideal material to treat the drilled skull holes in children's endoscopic neurosurgery and prevent CSF leaking afterwards. However, further investigation with more cases and longer follow-up was required to evaluate the clinical effect.