David Lisa R, Plikaitis Christina M, Couture Daniel, Glazier Steven S, Argenta Louis C
Department of Plastic and Reconstructive Surgery, Wake Forest University, Winston-Salem, North Carolina27157-1075, USA.
J Craniofac Surg. 2010 Jan;21(1):3-9. doi: 10.1097/SCS.0b013e3181c3469d.
Spring-assisted surgery (SAS) has demonstrated promising results for the treatment of sagittal craniosynostosis. The purpose of this study was to assess the outcomes of the first 75 cases compared with a prospectively collected group of patients treated with cranial expansion (cranial vault remodeling [CVR]).
Seventy-five children with scaphocephaly have completed this institutional review board-approved study. Patients underwent cranial surgery with removal of a 1-cm strip of sagittal suture and insertion of a mean of 2 spring distractors. Clinical outcome assessment included analysis of changes in cephalic index, shape, and volume on three-dimensional laser scans for both the SAS and the CVR treatments. Perioperative variables for both techniques were also compared.
All patients successfully underwent SAS without significant complications with a mean follow-up of 46 months. Perioperative variables including odds ratio, time, blood loss, transfusion requirements, intensive care unit and hospital stay lengths, and hospital costs differed significantly in favor of SAS. The mean cephalic index improved from 69 preoperatively to 75.4 after SAS, comparable with the change from 66 to 72.5 for CVR. This correction was maintained at 3- and 5-year follow-ups. Anterior frontal bossing was corrected on three-dimensional scan volume measurements.
Spring-assisted surgery is a safe, effective, minimally invasive treatment of scaphocephaly. It combines the low morbidity and the operative time of a strip craniectomy with dynamic reshaping techniques while the implanted spring gradually distracts the skull, improving head shape. Our 7 years of experience has shown that SAS effectively corrected cranial shape including frontal bossing with maintained results over time.
弹簧辅助手术（SAS）已在矢状缝早闭的治疗中显示出有前景的结果。本研究的目的是评估前75例患者的治疗结果，并与一组前瞻性收集的接受颅骨扩张术（颅穹窿重塑术[CVR]）治疗的患者进行比较。
75例舟状头患儿完成了这项经机构审查委员会批准的研究。患者接受颅骨手术，切除1厘米宽的矢状缝，并平均植入2个弹簧撑开器。临床结果评估包括对SAS和CVR治疗的三维激光扫描结果进行头指数、形状和体积变化分析。同时比较了两种技术的围手术期变量。
所有患者均成功接受了SAS手术，无明显并发症，平均随访46个月。围手术期变量包括比值比、时间、失血量、输血需求、重症监护病房和住院时间以及住院费用，SAS组均有显著优势。平均头指数从术前的69提高到SAS术后的75.4，与CVR组从66提高到72.5的变化相当。这种矫正效果在3年和5年随访时得以维持。通过三维扫描体积测量发现额前部突出得到了矫正。
弹簧辅助手术是一种安全、有效、微创的舟状头治疗方法。它将条带颅骨切除术的低发病率和手术时间与动态重塑技术相结合，同时植入的弹簧逐渐撑开颅骨，改善头部形状。我们7年的经验表明，SAS能有效矫正颅骨形状，包括额前部突出，且随着时间推移效果得以维持。
