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Cranioplasty after craniectomy in pediatric patients-a systematic review

Vita M Klieverik1, Kai J Miller1, Ash Singhal2

  • 1Department of Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, room G03.124, 3484, CX, Utrecht, The Netherlands.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|January 6, 2019
PubMed

Insights

Complications are common after pediatric cranioplasty using bone grafts or implants. More research is needed to improve surgical strategies and patient outcomes for cranioplasty in children.

Area of Science:

  • Neurosurgery
  • Pediatric Surgery
  • Biomaterials Science

Background:

  • Cranioplasty is frequently performed in pediatric patients following craniectomy.
  • Complications associated with both autografts and cranial implants are common.
  • Current literature lacks comprehensive data on cranioplasty strategies, complications, and long-term outcomes in children.

Purpose of the Study:

  • To systematically review the existing literature on cranioplasty practices in pediatric patients.
  • To provide an overview of current cranioplasty strategies, common complications, and reported outcomes.
  • To identify gaps in the literature and highlight the need for future research.

Main Methods:

  • A systematic literature review was conducted for articles published up to July 2018.
  • Studies included pediatric patients (<18 years) undergoing cranioplasty with a minimum 1-year follow-up.
  • Data on cranioplasty materials, complications, and revision rates were extracted and analyzed.

Main Results:

  • The review analyzed 24 manuscripts detailing 864 cranioplasty procedures in children (average age 8.0 years).
  • Autologous bone grafts (56.0%) and cranial implants (44.0%) were utilized, with resorption and infection being common complications for grafts, and infection/migration for implants.
  • Significant data gaps were identified regarding complication and revision rates for both methods, hindering comparative analysis.

Conclusions:

  • Post-cranioplasty complications are frequent in pediatric patients, irrespective of the material used (autografts or implants).
  • The current body of literature lacks standardized, well-documented outcome parameters for cranioplasty in children.
  • Prospective, long-term, multicenter cohort studies are essential to optimize cranioplasty strategies and improve outcomes for pediatric patients.
Abstract

Keywords:
ChildrenCraniectomyCranioplastyPediatric neurosurgery

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