Secondary Corrections for Single-Suture Craniosynostosis: Perioperative Outcomes and Predisposing Factors

Area of Science:

• Craniofacial surgery
• Pediatric neurosurgery
• Plastic surgery

Background:

• Many single-suture craniosynostosis corrections necessitate secondary remodeling procedures.
• The necessity for secondary procedures raises concerns about potentially higher complication rates and predisposing factors.

Purpose of the Study:

• To determine if secondary craniosynostosis remodeling procedures carry higher complication rates compared to primary corrections.
• To explore potential predisposing factors associated with the need for secondary remodeling procedures.

Main Methods:

• Retrospective chart review of patients undergoing primary and secondary craniosynostosis corrections.
• Data collected from a single center between 2010 and 2020.
• Analysis included complication rates, blood transfusion rates, length of stay, and predisposing factors.

Main Results:

• Of 491 single-suture corrections, 111 were secondary procedures (89.2% initially treated elsewhere).
• Surgical infection rates and median hospital length of stays were similar between primary and secondary groups.
• Younger age at primary correction (median 6 months vs. 12 months) was significantly associated with needing a second procedure, with a 40% odds reduction for each month increase in age.

Conclusions:

• This single-center review did not identify a higher risk profile for complications in secondary craniosynostosis remodeling procedures.
• Performing primary corrections at a younger age appears to be a significant factor associated with the need for subsequent secondary correction.
• Strip craniectomies may also be associated with a higher likelihood of requiring a secondary procedure.