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The Dura Split Technique in the Treatment of Craniosynostosis: Is It Still an Option?
Liisi Ripatti1, Richard Blair1,2, Willy Serlo3
1Department of Pediatric Surgery, Turku University Hospital, Turku.
Insights
The dura split technique for craniosynostosis surgery had acceptable outcomes and low reoperation rates. However, high complication rates, including bone defects and dural lesions, mean it is not recommended for future use.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Craniosynostosis is a condition requiring surgical intervention.
- The dura split technique is an older surgical method for craniosynostosis.
- Evaluating the safety and usability of this technique is important.
Purpose of the Study:
- To report the outcomes and complications of craniosynostosis surgery using the dura split technique.
- To assess the safety and current usability of the dura split technique.
Main Methods:
- Retrospective analysis of hospital records from Turku University Hospital (1975-2015).
- Inclusion of all pediatric patients surgically treated for craniosynostosis with the dura split technique.
- Evaluation of clinical and radiological outcomes, reoperation rates, and complications.
Main Results:
- The dura split technique was used in 65 patients.
- Most outcomes were good or acceptable, with only 3.1% requiring reoperation.
- Complications included significant blood loss (26.2%), dural lesions (21.5%), CSF leakage (13.8%), and bone defects (15.4% palpable, 63.1% radiological).
Conclusions:
- The dura split technique yielded mostly acceptable outcomes with rare reoperations.
- High rates of bone defects, dural lesions, and CSF leakage preclude future recommendations.
- This technique is not recommended for current craniosynostosis treatment.
Background:
The aim of this study was to report the outcome and the complications for patients operated on for craniosynostosis using the dura split technique. Specifically, the authors aimed to evaluate the safety of this technique, which is currently not in use, and to determine whether it is still useable.
Methods:
The data was collected from the hospital patient records of all children surgically treated for craniosynostosis using the dura split technique in Turku University Hospital during the period 1975 to 2015. The data was analyzed to determine the clinical and radiological outcomes of the surgical procedure, the need for reoperations, and the rate of complications.
Results:
During the study period, the dura split technique was used in the surgery of 65 patients. The outcome was either good or acceptable in most patients and reoperation was needed in only 2 patients (3.1%). Surgical complications included significant blood loss (26.2%), lesions on the inner layer of the dura (21.5%), leakage of cerebrospinal fluid (13.8%), and persistent bone defects (15.4% on palpation and 63.1% radiologically).
Conclusions:
Although the outcome of surgery for craniosynostosis using the dura split technique was mostly acceptable and the need for reoperations rare, the technique cannot, however, be recommended in the future due to high rates of bone defects, frequent problems with lesions on the inner layer of the dura, and consequent perioperative leakage of cerebrospinal fluid.
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