A Medical Insight on the of Biomaterials for Cranioplasty Surgery

Abstract:

Cranioplasty represent surgical repairs of defects or deformities of the skull which may come as a result of trauma or congenital malformations. The notable advance in cranioplasties came with the experimental groundwork in bone grafting, performed in the late 19th century, based on which, the use of autografts for cranioplasty became popular in the early 20th century. With the First and Second World Wars alternative metals and plastics were needed to cover large cranial defects suffered in combat as precious metals became scarce. As time passed metallic bone substitutes have gradually become obsolete and modern non-immunogenic plastics such as Polymethylmethacrylate (PMMA) snf Polyetheretherketone (PEEK) replaced them, the major downside of the technique being represented by the high costs. The authors present a statistic of 25 patients treated over a period of 4 years in 3 major neurosurgical units – which beneffited from the neurosurgical use of biomaterials for the repair of major cranial defects following congenital malformations, post-surgical cranial defects or trauma of the skull. We excluded large bone flaps for decompressive craniotomy. The authors used PMMA (Polymethylmethacrylate) and PEEK-based implants. There were 12 cases in which PMMA was used and 13 cases in which PEEK-based implants were used. The authors present a personal comparrison between the two materials. At the same time, the authors perform a comprehensive review of how the techniques have evolved from simple metal to modern biopolymers and how the modern technology will impact the future of cranial reconstruction

• Periodical: Key Engineering Materials (Volume 638)
• Pages: 205-209
• DOI: https://doi.org/10.4028/www.scientific.net/KEM.638.205
• Online since: March 2015
• Authors: Dumitru Mohan, Valentin Munteanu, Horatiu Moisa*, A.V. Ciurea
• Keywords: Biomaterials, Cranioplasty, Neurosurgery, Outcome

References

[1] Shah A. Jung H. Skirboll S. Materials used in cranioplasty: a history and analysis. Neurosurg. Focus. 2014 36(4): E19. Doi: 10. 3171/2014. 2. FOCUS13561.

DOI: 10.3171/2014.2.focus13561

[2] Lopez Pinero JM. Nine centuries of cranial surgery. Lancet 1999 Dec; 354. Suppl: SIV35.

DOI: 10.1016/s0140-6736(99)90378-1

[3] Ciurea AV. Tratat de Neurochirurgie Vol. 1. Bucharest Medical Publishing house (2010).

[4] Ciurea AV. Tratat de Neurochirurgie Vol. 2. Bucharest Medical Publishing house (2012).

[5] Seckin A. Kucukyuruk B. Cranioplasty: Review of materials and techniques. J. Neurosci Rural Pract. 2011 2(2): 162-167.

[6] Prolo DJ, Burres KP, McLaughlin WT, Christensen AH. Autogenous skull cranioplasty: Fresh and preserved (frozen), with consideration of the cellular response, Neurosurgery. 1979; 4: 18–29.

DOI: 10.1097/00006123-197901000-00005

[7] Viterbo F, Palhares A, Modenese E. Cranioplasty: The autograft option. J Craniofac Surg. 1995; 6: 80–3.

DOI: 10.1097/00001665-199501000-00019

[8] Gladstone HB, McDermott MW, Cooke DD. Implants for cranioplasty. Otolaryngol Clin North Am. 1995; 28: 381–400.

DOI: 10.1016/s0030-6665(20)30552-1

[9] Blake DP. The use of synthetics in cranioplasty: A clinical review. Mil Med. 1994; 159: 466–9.

[10] Drosos GI, Babourda E, Magnissalis EA, Giatromanolaki A, Kazakos K, Verettas DA. Mechanical characterization of bone graft substitute ceramic cements. Injury (1), (2011).

DOI: 10.1016/j.injury.2011.02.004

[11] Thien A, King NK, Ang BT, Wang E, Ng I. Comparison of Polyetheretherketone and Titanium Cranioplasty after Decompressive Craniectomy. World Neurosurg. 2014 Jun 5. pii: S1878-8750(14)00546-4.

DOI: 10.1016/j.wneu.2014.06.003

[12] Stefini R. Esposito G. Zanotti B. Iaccarino C. Fontanela MM. Servadei F. Unse of custom made porous hydroxyapatite implants for cranioplasty: postoperative analysis of complications in 1549 patients, Surg Neurol Int 2013 4: 12.

DOI: 10.4103/2152-7806.106290

[13] Liu JK, Gottfried ON, Cole CD, Dougherty WR, Couldwell WT. Porous polyethylene implant for cranioplasty and skull base reconstruction, Neurosurg Focus. 16(3): ECP1.

DOI: 10.3171/foc.2004.16.3.14

[14] Cabraja M, Klein M, Lehmann TN. Long-term results following titanium cranioplasty of large skull defects, Neurosurg Focus, 2009 26(6): E10.

DOI: 10.3171/2009.3.focus091

[15] Lad SP, Bagley JH, Karikari IO, Babu R, Ugiliweneza B, Kong M, Isaacs RE, Bagley CA, Gottfried ON, Patil CG, Boakye M. Cancer after spinal fusion: the role of bone morphogenetic protein, Neurosurgery. 2013 73(3): 440-9.

DOI: 10.1016/j.spinee.2013.07.018