Lu Yi, Hui Guozhen, Liu Fengqiang, Wang Zhengan, Tang Yuming, Gao Shuxing
Department of Neurosurgery, First Hospital of Jiaxing City, Jiaxing, China.
Br J Neurosurg. 2012 Apr;26(2):216-21. doi: 10.3109/02688697.2011.629699. Epub 2011 Nov 21.
After decompressive craniectomy, a deep-freeze-preserved autologous cranial bone graft can be used for cranioplasty to avoid immunoreaction against an artificial patch material. Autologous cranial bone grafts not only have better physical properties, such as heat conduction, compared to artificial patch materials, but they also have the advantages of a lower medical cost and satisfactory physical flexibility. The discussion over (99)Tc(m)-MDP SPECT static cranial bone tomography in the diagnosis of survival and regeneration in deep-freeze preservation autologous cranial bones after cranioplasty is valuable. Objective. To investigate whether deep-freeze-preserved autologous cranial bone grafts could survive and regenerate after autologous reimplantation.
The method of cranial bone preservation involved removing the cranial graft and sealing it in a double-layer sterile plastic bag under sterile surgical conditions. On the day of the cranioplasty operation, the cranial bone graft was disinfected by immersing it in 3% povidone-iodine for 30 minutes. At short-term (2 weeks), medium-term (3 months), and long-term (12 months) postoperative follow-up visits, (99)Tc(m)-MDP SPECT static cranial bone tomography was used to examine the reimplanted cranial bone. Results. There were no postoperative infections or seromas in all 16 cases. Two weeks following cranial bone graft reimplantation, the SPECT tomography showed some radioactivity uptake in the reimplanted cranial bone graft, which was lower than that in the cranial bone on the healthy side. At 3 months and 12 months after the operation, the radioactivity uptake in the reimplanted cranial bone graft was the same as that in the cranial bone on the healthy side. X-ray films showed blurred sutures in the reimplanted cranial bone graft at 12 months after surgery.
Reimplanted deep-freeze-preserved autologous cranial bone can survive in the short term and regenerate in the medium and long terms.
减压性颅骨切除术后，可使用深冻保存的自体颅骨移植片进行颅骨成形术，以避免对人工补片材料产生免疫反应。与人工补片材料相比，自体颅骨移植片不仅具有更好的物理特性，如热传导性，而且还具有医疗成本较低和物理柔韧性令人满意的优点。探讨（99）锝-亚甲基二膦酸盐单光子发射计算机断层扫描（SPECT）静态颅骨断层扫描在颅骨成形术后深冻保存自体颅骨存活与再生诊断中的价值很有意义。目的：研究深冻保存的自体颅骨移植片在自体再植入后能否存活及再生。
颅骨保存方法为在无菌手术条件下取出颅骨移植片并密封于双层无菌塑料袋中。在颅骨成形手术当天，将颅骨移植片浸泡于3%聚维酮碘中30分钟进行消毒。在术后短期（2周）、中期（3个月）和长期（12个月）随访时，使用（99）锝-亚甲基二膦酸盐SPECT静态颅骨断层扫描检查再植入的颅骨。结果：16例患者均未发生术后感染或血清肿。颅骨移植片再植入2周后，SPECT断层扫描显示再植入的颅骨移植片有一些放射性摄取，低于健康侧颅骨。术后3个月和12个月时，再植入的颅骨移植片的放射性摄取与健康侧颅骨相同。X线片显示术后12个月时再植入的颅骨移植片缝线模糊。
再植入的深冻保存自体颅骨可在短期内存活，并在中长期再生。
