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Aseptic bone-flap resorption after cranioplasty - incidence and risk factors
Ali Rashidi1, I Erol Sandalcioglu1, Michael Luchtmann1
1Department of Neurosurgery, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
Objective:
One of the common complications occurring after cranioplasty (CP) is aseptic bone-flap resorption (ABFR). Reoperation necessary because of the development of ABFR can lead to unfavorable complications during subsequent surgery using a synthetic skull implant, and also necessarily leads to higher costs. The aim of this study is to identify prognostic factors that may help to predict the development of ABFR.
Methods:
In this study, 303 CP surgeries performed between 2002 and 2017 were examined retrospectively to identify factors predicting the occurrence of ABFR. A number of these factors (e.g., time lapse between decompressive craniectomy (DC) and CP, bone-flap size, specific laboratory signs, and the reason for the original DC) were analyzed as possibly influencing the risk of developing ABFR.
Results:
ABFR of an autologous bone flap that subsequently required a CP with synthetic skull implants occurred in 10 of 303 patients (3.0%). CP timing and patients' Karnofsky Performance Scores (KPS) (p = 0.008; p = 0.012) were identified as significant factors with an impact on the development of ABRF. Age did not reveal a significant value, but statistical analysis shows a clear trend. The younger the age, the more likely it was that an ABFR would develop.
Conclusion:
The risk of ABFR lessens the longer the period of time elapsed between DC and CP. Age does not reveal a significant value, but statistical analysis shows that there is a clear trend.
