Incidence and Factors Correlating with Union and Resorption of Autologous Bone Cranioplasty in Buriram Hospital

Abstract

Background: Autologous bone reconstruction for skull defect is usually performed in neurosurgery practice. However, it associates with treatment failure due to bony union and resorption problems.
Objective: To investigate incidence and factors that correlated with bone union and resorption problems. The result can be used as a guide for neurosurgeons to select the appropriate materials for cranioplasty.
Methods: Retrospective study design, all patients who underwent cranioplasty by autologous bone flap and had post-operative computed tomography of brain at Buriram Hospital from 1 Jan 2013 - 31 Jan 2023.
Results: There were 54 patients. Incidence of good union in 33 patients (61.1%), partial union in 10 patients (18.5%), poor union in 11 patients (20.4%). Incidence of complete success in 27 patients (50.0%), partial success in 14 patients (25.9%), satisfactory in 6 patients (11.1%), partial failure in 3 patients (5.6%), complete failure in 4 patients (7.4%). Factors correlating with good bony union were age, skull fracture and bone gap. Factors correlating with bone resorption were age, skull fracture, bone gap and complications. The predictive factor of bony union and resorption was age of patients but can not find optimum cut-off point of age due to small sample size.
Conclusions: Autologous bone is good material that used to reconstruct skull defects in adult. For the operation should be use solid fixation and smallest distance between bone edge. However, autologous bone is associated with failure treatment in young patients or skull fracture patients. The suggestion is to avoid autologous bone use in pediatric patients or skull fracture patients to reduce post-operative complication.