Resorption of Autogenous Bone Graft in Cranioplasty: Resorption and Reintegration Failure
Korean Journal of Neurotrauma 2014³â 10±Ç 1È£ p.10 ~ p.14
À̽ÃÈÆ(Lee Si-Hoon) - Gachon University Gil Medical Center Department of Neurosurgery
À¯ÂùÁ¾(Yoo Chan-Jong) - Gachon University Gil Medical Center Department of Neurosurgery
À̾ð(Lee Uhn) - Gachon University Gil Medical Center Department of Neurosurgery
¹Úö¿Ï(Park Cheol-Wan) - Gachon University Gil Medical Center Department of Neurosurgery
ÀÌ»ó±¸(Lee Sang-Gu) - Gachon University Gil Medical Center Department of Neurosurgery
±è¿ì°æ(Kim Woo-Kyung) - Gachon University Gil Medical Center Department of Neurosurgery
Abstract
Objectives Re-implantation of autologous skull bone has been known to be difficult because of its propensity for resorption. Moreover, the structural characteristics of the area of the defect cannot tolerate physiologic loading, which is an important factor for graft healing. This paper describes our experiences and results with cranioplasty following decompressive craniectomy using autologous bone flaps.
Methods: ?In an institutional review, the authors identified 18 patients (11 male and 7 female) in whom autologous cranioplasty was performed after decompressive craniectomy from January 2008 to December 2011. We examined the age, reasons for craniectomy, size of the skull defect, presence of bony resorption, and postoperative complications.
Results: Postoperative bone resorption occurred in eight cases (44.4%). Among them, two experienced symptomatic breakdown of the autologous bone graft that required a second operation to reconstruct the skull contour using porous polyethylene implant (Medpor¢ç). The incidence of bone resorption was more common in the pediatric group and in those with large cranial defects (>120 cm2). No significant correlation was found with sex, reasons for craniectomy, and cryopreservation period.
Conclusion: The use of autologous bone flap for reconstruction of a skull defect after decompressive craniectomy is a quick and cost-effective method. But, the resorption rate was greater in children and in patients with large skull defects. As a result, we suggest compressive force of the tightened scalp, young age, large skull defect, the gap between bone flap and bone edge and heat sterilization of autologous bone as risk factors for bone resorption.
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Autologous transplant, Cranioplasty, Resorption
KMID :
1143720140100010010
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