Page 114 - Clinical relevance of current materials for cranial implants

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Chapter 5
Complication predicting factors
The number of complications associated with the patient- and surgery-specific factors is listed in Table 1. Statistical analysis of the different risk factors did not show a significant increase in complication rates.
There was no significant difference in mean age between patients who developed a complication (50 ± 18 years) and those who did not (40 ± 18 years). The presence of comorbidity did not seem to be related to a higher complications rate, except for patients with vascular comorbidity. They were more likely to get any complication than patients without vascular disease (40% vs. 25%). This was also found for smoking behavior (40% vs. 25%). Concerning the original indication for craniectomy, tumor patients were less likely to develop complications (13% vs. 33%) and stroke patients were more likely to get complications (40% vs. 22%). Although cranioplasty timing did not show statistical significance, we observed 9 of 11 complications (82%) in the delayed cranioplasty group. After previous cranioplasty with autologous bone, and even in those cases where autologous bone was lost due to infection, no association with higher complication rates was found. One case of skin flap necrosis was observed in a patient where additional incisions were made. When comparing PEEK PSI’s with InterFix technology and other PSIs we did not find a significant difference in the complication rate (28% vs. 27%).
Neurological status assessment
Neurological status assessment is summarized in Figure 3. One patient was lost to follow-up (N/A). Eighteen patients had a normal neurological status before and after cranioplasty. Ten patients (53%) with neurological impairment showed no change in neurological status after PEEK cranioplasty. Eight patients (42%) showed a moderate improvement and one patient (5%) showed a significant improvement of the neurological status following PEEK cranioplasty. There were no patients showing neurological deterioration after PEEK reconstruction.