Early autologous cranioplasty: complications and identification of risk factors using virtual reality visualisation technique.

Abstract:

:Background: Cranioplasty (CP) of autologous bone flap after decompressive craniectomy (DC) is known to be associated with a high complication rate, particularly bone flap resorption (BFR). In a retrospective study, we used a novel virtual reality (VR) visualisation technique to identify and evaluate risk factors associated with CP.Method: Twenty-five patients underwent early autologous CP. All complications were recorded. Cranial computed tomography scans were visualised via the VR software to access the fitting accuracy of the bone flap (bone flap size, gap width at trepanation cutting edge, extent of osteoclastic extension).Results: An overall complication rate of 44% was seen, and BFR was the most common (36%). Only 'osteoclastic extension of trepanation' (p   = .04) was a significant risk factor for BFR. The factors 'indication for DC' (p   = .09) and 'size of bone flap' (p   = .09) had a tendency towards influencing the rate of BFR, while 'age' (p   = .68), 'time interval between DC and CP' (p   = 1.00), and 'gap width' (p   = .50) were not considered to influence the BFR rate.Conclusions: DC and subsequent CP is a complication-prone procedure. Therefore, it is relevant to identify and quantify probable risk factors for the most common complications, such as BFR. Here, we found that the extent of osteoclastic extension may impair the patient's healing process. Our investigation was made considerably easier by using the novel VR visualisation technique, which allows parallax free measurements of distances in 3D space.

journal_name

Br J Neurosurg

authors

Zawy Alsofy S,Stroop R,Fusek I,Sakellaropoulou I,Lewitz M,Nakamura M,Ewelt C,Fortmann T

doi

10.1080/02688697.2019.1661962

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

664-670

issue

6

eissn

0268-8697

issn

1360-046X

journal_volume

33

pub_type

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