The Evolving Role of Springs in Craniofacial Surgery: The First 100 Clinical Cases

Lauritzen, Christian; Davis, Charles R.; Ivarsson, Anna; Sanger, Claire; Hewitt, Timothy

doi:10.1097/01.prs.0000297638.76602.de

Cited by 199 publications

(121 citation statements)

References 7 publications

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“…9,12,22 The male to female ratio showed a higher proportion of females with bicoronal and unilateral coronal craniosynostosis, which is similar to results in past studies. 12 Our patients with secondary craniosynostosis had lower mean gestational ages and mean birth weights, which we presume is a natural phenomenon due to overall brain and systemic underdevelopment.…”

Section: Results Of the Tsdo Operative Technique In 285 Children Withsupporting

confidence: 81%

“…Also, the distraction direction vector cannot be adjusted, and thus there is an increased risk of complications, such as bleeding, CSF leakage, subdural space widening, and unwarranted less expansion or overexpansion of the cranium with undesirable cosmetic consequences. 12,13 At present, no studies or information exist on the proper and safe expansion distance in any of the DO surgical techniques, including TSDO, so that determination of this factor is difficult.…”

Section: Discussion Advantages and Limitations Of The Tsdo Operative mentioning

confidence: 99%

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Transsutural distraction osteogenesis for 285 children with craniosynostosis: a single-institution experience

Park

Yoon

2016

PED

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OBJECT Although distraction osteogenesis (DO) requires a secondary procedure in the surgical correction of craniosynostosis, it is relatively simple, requires less transfusion, results in a shorter intensive care unit stay, and is quite safe. Because of these positive factors, various DO techniques have been developed. However, there is disagreement regarding the superiority of DO. The authors reported on a new DO technique, transsutural DO (TSDO), 6 years ago that was performed in 23 patients over a period of 6 months, and it continues to be used at the present time. In this paper the authors report the results of TSDO performed in 285 patients with craniosynostosis over a period of 6 years at a single institution. METHODS TSDO consists of a simple suturectomy of the pathological suture followed by direct distraction of the suturectomy site only. Types of TSDO conducted included sagittal TSDO in 95 patients, bicoronal in 14, unilateral coronal in 57, lambdoid in 26, metopic in 13, multiple in 19, syndromic in 33, and secondary in 28. The mean age (± SD) of the patients was 19.4 ± 23.0 months, and mean follow-up was 39.5 ± 21.0 months. RESULTS The mean operating time was 115 ± 43 minutes, and mean anesthesia time was 218 ± 56 minutes. The mean transfusion volume of red blood cell components was 48 ± 58 ml, and mean transfusion volume of fresh-frozen plasma was 19 ± 35 ml. Total transfusion volume was significantly less in infants younger than 12 months of age and in children with lower lumbar puncture pressures (p < 0.05). Complications included 1 (0.4%) death from postoperative acute pneumonia after a distractor removal operation and 23 (8%) surgical morbidities comprising 10 revisions (3.5%) and 13 early removals of distracters (4.6%). CONCLUSIONS TSDO is a simple, effective, and safe method to use for treating all types of craniosynostosis. Some morbidity was experienced in this study, but it may be attributed to the learning curve of the technique.

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Section: Results Of the Tsdo Operative Technique In 285 Children Withsupporting

confidence: 81%

Section: Discussion Advantages and Limitations Of The Tsdo Operative mentioning

confidence: 99%

Transsutural distraction osteogenesis for 285 children with craniosynostosis: a single-institution experience

Park

Yoon

2016

PED

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“…As reported by Gewalli et al 5 , despite the quick opening of the spring when compared to the established bone distraction procedures 17 , ossification takes place in the gap between the stumps distracted by springs. We agree with the hypothesis that a smaller detachment of the dura mater may be associated to this finding 18 , which is clearly evidenced by Gosain 19 who also observed that the defect created in adult animals was maximized by the maintenance of contact with the pericranium (bone growth from peripheral areas) and dural contact (bone growth from the central area).…”

Section: Discussionmentioning

confidence: 78%

“…In 1998 and 2003, Lauritzen et al 3 described two clinical cases of patients with craniosynostosis using dynamic expansion with implantable internal springs and in 2001, they reported an experimental study showing changes in the growth of rabbit skulls using springs 4 . In 2008, they published the first 100 cases using this device 5 .…”

Section: Introductionmentioning

confidence: 99%

Spring-mediated skull expansion: overall effects in sutural and parasutural areas. An experimental study in rabbits

Dornelles

Cardim

Trierveiler³

et al. 2010

Acta Cir. Bras.

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PURPOSE: The use of springs in cranial expansion has proven to be effective in the treatment of craniosynostosis. Spring-mediated expansion has been studied both in the sagittal and in parasagittal regions, especially in scaphocephaly. A rabbit model was used in the present study to analyze the effects of springs on the cranial vault and sutures. METHODS: Thirteen 4-week-old New Zealand rabbits were divided into 4 groups: in group I, only amalgam markers were used as control; in group II, amalgam markers were used and sagittal suturectomy was performed; in group III, amalgam markers were used, a sagittal suturectomy was performed and an expansible spring was fitted in the interparietal region and in group IV, markers were used and linear parasagittal craniectomy was carried out with springs. Animals were sacrificed after 2, 4, 8 and 12 weeks. Radiological control and histological analysis were performed in the area of spring implantation. RESULTS: In the groups using springs distraction of the craniectomy borders was greater than in those that did not use springs. New bone formation was observed in all groups, and was faster in group II. Bone growth started from the borders and depth. Bone regeneration presented a similar histological pattern in the groups with spring in the sagittal and parasagittal region. CONCLUSION: The rabbit model proved to be adequate for the analysis proposed by the study. The use of springs in the groups with sagittal and parasagittal osteotomy led to a similar distraction of amalgam markers and both groups had similar ossification histological pattern.

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“…The action of springs in infant skulls with malleable bones of membranous nature is not exclusively restricted to bone edges, but extends to adjacent cranial vault. In the first 100 cases, Lauritzen et al (Lauritzen, Davis et al 2008) indicated springs for treating metopic, bicoronal, multisutural synostosis, advancements of the middle third of the face, and others. No serious complications were observed.…”

Section: Expansible Springsmentioning

confidence: 99%

Skull Expansion by Spring-Mediated Bone Regeneration

Dornelles¹,

Cardim²,

Alonso³

2012

Bone Regeneration

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The Evolving Role of Springs in Craniofacial Surgery: The First 100 Clinical Cases

Cited by 199 publications

References 7 publications

Transsutural distraction osteogenesis for 285 children with craniosynostosis: a single-institution experience

Transsutural distraction osteogenesis for 285 children with craniosynostosis: a single-institution experience

Spring-mediated skull expansion: overall effects in sutural and parasutural areas. An experimental study in rabbits

Skull Expansion by Spring-Mediated Bone Regeneration

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