Department News

DYNAMIC SPRING MEDIATED CRANIOPLASTY FOR THE TREATMENT OF CRANIOSYNOSTOSIS PASSES THE TEN YEAR MARK OF CLINICAL UTILIZATION AT WAKE FOREST UNIVERSITY

Craniosynostosisis the premature closure of one or more cranial sutures. The most common type, scaphocephaly, results from the premature closure of the sagittal suture. The treatment of this condition is surgical intervention to release this abnormal suture and correct the head shape abnormalities.  Many types of surgical techniques have been described to treat this problem. The gold standard has been a procedure known as cranial vault reconstruction (CVR) and is a significant operation requiring a 4 to 5 day hospital stay, blood transfusions, and a prolonged recovery period.

More recently a craniofacial surgeons are focusing on minimally invasive procedures to accomplish the same long term results.  Spring mediated cranioplasty was first developed in Sweden by Dr. Claus Lauritzen in 1997. 

Dr. Lisa David, one of our craniofacial surgeons, studied with Dr. Lauritzen and has been doing this procedure at Wake Forest Baptist Medical Center beginning in April, 2001.  Dr. David together with Dr. Daniel Couture, our pediatric neurosurgeon, have performed more than 120 cases with good clinical success.


*The wounds shown here are intended for medical purposes and are graphic in nature.
*Click here to view images from the craniosynostosis procedure.
*Click here to view before and after pictures of a child treated with spring mediated cranioplasty.

Description of Procedure:

    1. An incision is made across the top of a child’s head instead of side to side.  Dr.Couture, our neurosurgeon, then removes the fused sagittal suture. Two dynamic springs made of spring steel are designed in the operating room by Dr. David and placed in the gap where the fused suture was removed. The incision is closed with absorbable suture.
    2. An intensive care unit stay should not be needed and the child is kept overnight for observation on the pediatric floor. The child is sent home when he/she is eating, has good pain control, and spring placement and movement is confirmed by X-rays.
    3. Three to 4 months after the surgery when the head has reshaped, the child has a second smaller operation to remove the 2 springs. The second operation consists of opening a portion of the previous incision and pulling the springs out. This is a minor procedure and the child is able to go home the next day.

No major complications or adverse reactions have been seen with use of these springs. Risks include those associated with any cranial surgery, which include infection, bleeding, anesthesia, and scarring.

Children directly benefit from this surgical treatment. These benefits may include a less invasive operation, decreased need for a blood transfusion, a shorter hospital stay, and a smaller scar. Additionally, information will be gained for future patients regarding this treatment.

The alternative is to use the current standard techniques of removal of the fused suture and reshaping of the head.

Should you have any questions about this treatment please feel free to contact the Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine, 336-716-4171 or the Department of Neurosurgery, Wake Forest School of Medicine, 336-716-4101.

 

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Last Updated: 10-08-2013
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