Page 43 - Clinical relevance of current materials for cranial implants

Table 4: Other reported complications and policies after cranioplasty (n= 10,346)
Autologous bone is inferior to alloplastic cranioplasties
Complications
Hematoma Seroma
Infection
Second trauma Wound problems Exposure Migration implant Bone resorption CSF leak
Epilepsy
Seizures
Death
Other
Total
Policies
Expectant
Surgery
Antibiotics Removal
Wound debridement Other
Total n (%)
196 (1.9) 69 (0.7) 550 (5.6) 9 (0.1) 111 (1.1) 58 (0.6) 18 (0.2) 226 (5.2) 143 (1.4) 14 (0.1) 74 (0.7) 44 (0.4) 440 (4.3) 1952 (18.9)
168 (4.8) 232 (2.2) 30 (0.3) 565 (6.6) 17 (0.2) 5 (0.0)
PEEK n (%)
9 (4.0) 1 (0.7) 14 (5.9) 0 (0) 3 (1.3) 2 (0.6) 0 (0) 0 (0) 3 (1.3) 1 (0.4) 6 (2.6) 0 (0) 10 (4.4) 49 (21.3)
11 (4.8) 11 (4.8) 1 (0,4) 18 (7.4) 0 (0) 0 (0)
PMMA n (%)
31 (2.1)
8 (0.5)
122 (7.8) 1 (0.1) 8 (0.5) 11 (0.7) 7 (0.5) 1 (0.2) 10 (0.7) 0 (0) 11 (0.7) 4 (0.3) 41 (2.8) 255 (16.8)
17 (1.1) 43 (2.9) 5 (0.3) 104 (7.9) 4 (0.1) 3 (0.2)
Titanium n (%)
50 (2.8) 27 (1.5) 93 (5.4) 0 (0) 23 (1.3) 27 (1.5) 1 (0.1) 0 (0) 14 (0.8) 0 (0) 24 (1.4) 1 (0.1) 123 (7.0) 383 (22.0)
44 (2.5) 35 (2.0) 10 (0.6) 100 (6.7) 2 (0.1)
0 (0)
Autologous n (%)
58 (2.3) 9 (0.4) 210 (6.9) 0 (0) 27 (1.1) 4 (0.2) 7 (0.3) 222 (11.3) 68 (2.7) 13 (0.5) 28 (1.1) 35 (1.4) 200 (7.8) 881 (35.7)
72 (2.8) 117 (4.6) 6 (0.2) 250 (10.4) 0 (0)
0 (0)
HA n (%)
14 (1.7) 5 (0.6) 29 (3.3) 8 (0.9) 8 (0.9) 13 (1.5) 0 (0)
1 (0.4) 1 (0.1) 0 (0) 0 (0) 0 (0) 9 (1.1) 88 (10.5)
18 (2.1) 3 (0.4) 3 (0.4) 21 (2.5) 10 (1.2) 2 (0.2)
Other n (%)
8 (0.3) 5 (0.2) 82 (3.5) 0 (0) 42 (1.8) 0 (0)
1 (0.0) 2 (0.2) 22 (1.0) 0 (0) 0 (0)
1 (0.0) 49 (2.1) 212 (9.2)
5 (0.2) 17 (0.7) 3 (0.1) 72 (3.2) 1 (0) 0 (0)
Unknown
n (%) 2
26 (2.2) 14 (1.2) -
0 (0) 0 (0) 1 (0.1) 2 (0.2) -
25 (2.2) 0 (0) 5 (0.4) 3 (0.3) 8 (0.7) 84
1 (0.1) 6 (0.5) 2 (0.2) -
0 (0) 0 (0)
PEEK: poly(ether ether ketone) PMMA: poly(methyl methacrylate) HA: hydroxyapatite
Neurological function
The GCS and GOS scores varied from 5 to 15 and 1 to 5 respectively. Twenty-two of 44 studies reported the neurological outcome in a subjective manner. Both numerical and subjective studies showed high heterogeneity ranging from ‘Nine of 12 (75%) patients with neurological disability showed some improvement in neurological status’63 to the GOS ‘improved significantly after the cranioplasty’8.
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