Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Bone Flap Resorption Following Cranioplasty with Autologous Bone : Quantitative Measurement of Bone Flap Resorption and Predictive Factors

  • Park, Sang Pil (Department of Neurosurgery, Eulji University Eulji Hospital) ;
  • Kim, Jae Hoon (Department of Neurosurgery, Eulji University Eulji Hospital) ;
  • Kang, Hee In (Department of Neurosurgery, Eulji University Eulji Hospital) ;
  • Kim, Deok Ryeong (Department of Neurosurgery, Eulji University Eulji Hospital) ;
  • Moon, Byung Gwan (Department of Neurosurgery, Eulji University Eulji Hospital) ;
  • Kim, Joo Seung (Department of Neurosurgery, Eulji University Eulji Hospital)
  • Received : 2017.03.08
  • Accepted : 2017.08.02
  • Published : 2017.11.01
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Abstract

Objective : To quantitatively measure the degree of bone flap resorption (BFR) following autologous bone cranioplasty and to investigate factors associated with BFR. Methods : We retrospectively reviewed 29 patients who underwent decompressive craniectomy and subsequent autologous bone cranioplasty between April 2005 and October 2014. BFR was defined as : 1) decrement ratio ([the ratio of initial BF size/craniectomy size]-[the ratio of last BF/craniectomy size]) >0.1; and 2) bone flap thinning or geometrical irregularity of bone flap shape on computed tomographic scan or skull plain X-ray. The minimal interval between craniectomy and cranioplasty was one month and the minimal follow-up period was one year. Clinical factors were compared between the BFR and no-BFR groups. Results : The time interval between craniectomy and cranioplasty was $175.7{\pm}258.2$ days and the mean period of follow up was $1364{\pm}886.8$ days. Among the 29 patients (mean age 48.1 years, male : female ratio 20 : 9), BFR occurred in 8 patients (27.6%). In one patient, removal of the bone flap was carried out due to severe BFR. The overall rate of BFR was $0.10{\pm}0.11$ over 3.7 years. Following univariate analysis, younger age ($30.5{\pm}23.2$ vs. $54.9{\pm}13.4$) and longer follow-up period ($2204.5{\pm}897.3$ vs. $1044.1{\pm}655.1$) were significantly associated with BFR (p=0.008 and 0.003, respectively). Conclusion : The degree of BFR following autologous bone cranioplasty was 2.7%/year and was associated with younger age and longer follow-up period.

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References

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