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- Outcomes of Cranioplasty Using Autologous Bone or 3D-Customized Titanium Mesh Following Decompressive Craniectomy for Traumatic Brain Injury: Differences in Complications
- Junwon Kim, Jang Hun Kim, Jong Hyun Kim, Taek-Hyun Kwon, Haewon Roh
- J Trauma Inj. 2019;32(4):202-209. Published online December 30, 2019
- DOI: https://doi.org/10.20408/jti.2019.033
- 6,278 View
- 113 Download
- 6 Citations
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Abstract
PDF Purpose Cranioplasty (CP) is often required for survival after decompressive craniectomy. Several materials, including autologous bone and various artificial materials, have been introduced for CP, but it remains unclear which material is best for CP. This study aimed to explore differences in complications between patients who underwent CP using an autologous bone flap versus a three-dimensional (3D) titanium mesh and to identify significant risk factors for post-CP complications.
Methods In total, 44 patients were enrolled in this study and divided into two groups (autologous bone vs. 3D titanium mesh). In both groups, various post-CP complications were evaluated. Through a comparative analysis, we aimed to identify differences in complications between the two groups and, using binary logistic analysis, to determine significant factors associated with complications after CP.
Results In the autologous bone flap group, there were three cases of surgical infection (3/24, 12.5%) and 11 cases of bone flap resorption (BFR) (11/24, 45.83%). In the 3D titanium mesh group, there was only one case of surgical infection (1/20, 5%) and 11 cases of various complications, including mainly cosmetic issues (11/20, 55%). A subgroup risk factor analysis of CP with an autologous bone flap showed no risk factors that predicted BFR with statistical significance, although a marginal association was found between larger bone flaps and BFR (odds ratio [OR]=1.037,
p =0.090). In patients treated with a 3D titanium mesh, multivariate analysis revealed that only the existence of a ventriculo-peritoneal shunt system was strongly associated with overall post-CP complications (OR=18.66,p =0.021).Conclusions Depending on which material was used, different complications could occur, and the rate of complications was relatively high in both groups. Hence, the material selected for CP should be selected based on individual patients’ conditions.
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Summary
Citations
Citations to this article as recorded by
- Customized Additive Manufacturing in Bone Scaffolds—The Gateway to Precise Bone Defect Treatment
Juncen Zhou, Carmine Wang See, Sai Sreenivasamurthy, Donghui Zhu
Research.2023;[Epub] CrossRef - Customized cost-effective polymethylmethacrylate cranioplasty: a cosmetic comparison with other low-cost methods of cranioplasty
Manish Baldia, Mathew Joseph, Suryaprakash Sharma, Deva Kumar, Ashwin Retnam, Santosh Koshy, Reka Karuppusami
Acta Neurochirurgica.2022; 164(3): 655. CrossRef - Letter to the Editor: Complications following titanium cranioplasty compared with nontitanium implants cranioplasty: A systematic review and meta-analysis
Michael Amoo, Jack Henry
Journal of Clinical Neuroscience.2021; 87: 32. CrossRef - Complications of Cranioplasty in Relation to Material: Systematic Review, Network Meta-Analysis and Meta-Regression
Jack Henry, Michael Amoo, Joseph Taylor, David P O’Brien
Neurosurgery.2021; 89(3): 383. CrossRef - Comparison of complications in cranioplasty with various materials: a systematic review and meta-analysis
Liming Liu, Shou-Tao Lu, Ai-Hua Liu, Wen-Bo Hou, Wen-Rui Cao, Chao Zhou, Yu-Xia Yin, Kun-Shan Yuan, Han-Jie Liu, Ming-Guang Zhang, Hai-Jun Zhang
British Journal of Neurosurgery.2020; 34(4): 388. CrossRef - A Reappraisal of the Necessity of a Ventriculoperitoneal Shunt After Decompressive Craniectomy in Traumatic Brain Injury
Seunghan Yu, Hyuk Jin Choi, Jung Hwan Lee, Mahnjeong Ha, Byung Chul Kim
Journal of Trauma and Injury.2020; 33(4): 236. CrossRef
Case Reports- Non-Operatively Treated Thoracolumbar Burst Fracture with Posterior Ligamentous Complex Injury: Case Report and Consideration on the Limitation of Thoracolumbar Injury Classification and Severity (TLICS) Score
- Woo-Keun Kwon, Jong-Keon Oh, Jun-Min Cho, Taek-Hyun Kwon, Youn-Kwan Park, Hong Joo Moon, Joo Han Kim
- J Trauma Inj. 2018;31(2):76-81. Published online August 31, 2018
- DOI: https://doi.org/10.20408/jti.2018.31.2.76
- 4,322 View
- 69 Download
- 1 Citations
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Abstract
PDF
Fractures at the thoracolumbar region are commonly followed after major traumatic injuries, and up to 20% of these fractures are known to be burst fractures. Making surgical decisions for these patients are of great interest however there is no golden standard so far. Since the introduction of Thoracolumbar Injury Classification and Severity (TLICS) score in 2007, it has been widely used as a referential guideline for making surgical decisions in thoracolumbar fractures. However, there is still limitations in this system. In this clinical case report, we introduce a L1 burst fracture after motor vehicle injury, who was successfully treated conservatively even while she was graded as a TLICS 5 injury. A case report is presented as well as discussion on the limitations of this grading system.
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Summary
Citations
Citations to this article as recorded by- Nonoperative Management in Intact Burst Fracture Patient With Thoracolumbar Injury Classification and Severity Score of 5: A Case Report
Gersham J Rainone, Yash Patel, Cody Woodhouse, Ryan Sauber, Alexander Yu
Cureus.2022;[Epub] CrossRef
- A Rare Case of Lumbar Traumatic Intradiscal Hematoma Followed by Repeatative Occupation Related Minor Trauma
- Woo-Keun Kwon, Jong-Keon Oh, Taek-Hyun Kwon, Youn-Kwan Park, Hong Joo Moon, Joo-Han Kim
- J Trauma Inj. 2018;31(1):38-42. Published online April 30, 2018
- DOI: https://doi.org/10.20408/jti.2018.31.1.38
- 4,138 View
- 112 Download
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Abstract
PDF
A case of surgically treated intervertebral disc extrusion with intraoperatively confirmed intradiscal hematoma in a 30-year-old physical trainer is presented. Preoperative magnetic resonance imaging revealed downward migrating disc herniation, without definite suggestive findings of intradiscal hematoma. Intervertebral disc herniation with concomitant intradiscal hematoma is extremely rare, but could occur in patients who have excessive axial stress to the spine occupationally. In our case, the patient was an occupational physical trainer who had repetitive minor trauma to the lumbar spine. Although the patient did not have any clear history of major trauma to the spine, the intraoperative findings revealed intradiscal hematoma, which is very rare. The presence of intradiscal hematoma is to be suspected even when preoperative imaging studies shows indefinite findings of hematoma, considering the change in signal intensity of hematoma by time.
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