Spring-Assisted Cranioplasty in Multisuture Craniosynostosis: Initial Experience From Thailand.

Area of Science:

• Neurosurgery
• Pediatric Surgery
• Craniofacial Surgery

Background:

• Craniosynostosis involves premature fusion of cranial sutures, leading to abnormal head shape.
• Multisuture craniosynostosis presents complex challenges for surgical correction.
• Spring-assisted cranioplasty is a dynamic, minimally invasive technique for cranial expansion.

Purpose of the Study:

• To describe the initial application of spring-assisted cranioplasty in Thailand.
• To evaluate its efficacy in posterior vault expansion for multisuture craniosynostosis.
• To assess outcomes in pediatric patients with complex cranial deformities.

Main Methods:

• Two pediatric patients with multisuture craniosynostosis underwent posterior vault expansion using custom-fabricated stainless steel springs.
• A parieto-occipital strip craniectomy was performed, followed by the placement of four springs per patient.
• Springs were removed postoperatively, and clinical and radiological outcomes were assessed.

Main Results:

• Substantial cranial expansion was achieved in both patients, with significant improvement in cephalic index.
• Operative times and blood loss were reduced compared to traditional methods.
• No bony encasement of springs occurred, and both children demonstrated appropriate developmental progress.

Conclusions:

• Spring-assisted cranioplasty is a feasible and cost-effective option for posterior vault expansion in complex craniosynostosis.
• The technique offers benefits including reduced operative time, blood loss, and effective cranial reshaping.
• Careful patient selection, particularly for shunt-dependent cases, is crucial for successful outcomes.