Application of computer assisted three-dimensional simulation operation and biomechanics analysis in the treatment of sagittal craniosynostosis.

UNLABELLED

As a surgical method to treat children with sagittal craniosynostosis, calvarial vault reconstruction is subjected to some limitations. In traditional surgical method to treat children with sagittal craniosynostosis, surgical resection and fixation are performed all by the experience of surgical doctor, which is likely to cause individual differences, insecure fixation, configurational asymmetry, and waste of unnecessary fixtures materials. This study aims to provide surgical doctor with objective indicators via 3D simulation combined with biomechanical calculation, so as to improve the surgical efficiency.

METHODS

The aim of this study is to compare preoperative strategy integrating computer-assisted 3D simulation and biomechanical calculation and traditional strategy. A retrospective method was used to compare the effect and difference between these 2 strategies. The clinical data of 18 patients with sagittal synostosis were collected and compared. Among them, 10 patients were enrolled in Group A applied with traditional treatment method, while 8 were enrolled in Group B applied with preoperative strategy integrating computer-assisted 3D simulation and biomechanical calculation. The aim of this study is to evaluate two treatment methods by investigating indexes between two groups, such as length of operation, blood loss, operation cost, and postoperative complications. Through comparing the cranial index, head circumference, and cranial vault asymmetry index of two groups before and after treatment, the surgical effects of two groups can be evaluated. Moreover, biomechanical analyses for two groups were conducted.

RESULTS

Regarding group B, the length of operation was (217±29.3min), blood loss was (70±11.7ml), operation cost was (34,495±8662¥); while for group A, the length of operation was (276±23.5min), blood loss was (90±15.5ml), operation cost was (25,149±4133¥). No postoperative complication was observed for group B, while there was 1 case of central nervous system infection occurred in group A. The cranial indexes of both groups were significantly improved after treatment. The head circumferences of both groups were insignificantly changed after treatment. Through comparing the cranial vault asymmetry index of two groups before and after treatment, the cranial vaults of patients of group A were not so symmetrical as Group B after treatment.

CONCLUSIONS

This research proposes the application of preoperative strategy integrating computer-assisted 3D technique and biomechanical analysis, which allows surgical doctors to have a clear understanding on the surgical process before operation. In particular, this new treatment method for the first time adopts biomechanical calculation to determine the setting position and setting quantity of fixtures materials, so as to realize a firm and symmetrical effect, reduce waste of unnecessary fixtures materials, increase surgical efficiency, reduce length of operation, blood loss, and occurrence of postoperative complications Computer-assisted 3D technique with biomechanical analysis is a new advanced technique for the treatment of sagittal craniosynostosis.