Analysis of clinical efficiency and early postoperative complications after cranioplasty

Bratisl Lek Listy. 2021;122(7):461-468. doi: 10.4149/BLL_2021_076.

Abstract

Introduction: Despite of being considered a routine procedure, cranioplasty is associated with a substantial risk of failure, or postoperative complications.

Patients and methods: Postoperative clinical course and rate of complications was assessed in patients undergoing cranioplasty during years 2015-2019 in a retrospective fashion.

Results: The most frequent condition requiring cranioplasty was a presence of bone defect after a decompressive craniectomy for traumatic brain injury (45 patients). Revision was needed in 9 cases (12.68 %), removal of the bone flap was necessary in 5 patients (7.04 %). The most common complication observed was an unintended intraoperative durotomy, occurring in 9 patients (12.68 %), which was, however, not associated with an increased risk of reoperation. Postoperative improvement of motor functions was observed in 7 patients (9.86 %). Improvement of consciousness occurred in 8 patients (11.27 %). Early cranioplasty was associated with significantly higher odds for surgical revision, patients after previous craniectomy for traumatic brain injury had significantly increased odds for the overall occurrence of complications.

Conclusions: After a cranial reconstruction, complications with a various degree of severity may occur and even the result in need of the implant removal. Postoperative improvement of focal neuro-deficit is possible as well as improvement on the level of patient's consciousness (Tab. 2, Fig. 2, Ref. 61).

Keywords: craniectomy; cranioplasty; outcome complications..

MeSH terms

  • Decompressive Craniectomy* / adverse effects
  • Humans
  • Plastic Surgery Procedures*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Skull / surgery
  • Treatment Outcome