Gutman Matthew J, How Elena, Withers Teresa
Department of Neurosurgery, Gold Coast University Hospital, Southport, Australia.
Surg Neurol Int. 2017 Jun 27;8:130. doi: 10.4103/sni.sni_460_16. eCollection 2017.
The "floating anchored" craniotomy is a technique utilized at our tertiary neurosurgery institution in which a traditional decompressive craniectomy has been substituted for a floating craniotomy. The hypothesized advantages of this technique include adequate decompression, reduction in the intracranial pressure, obviating the need for a secondary cranioplasty, maintained bone protection, preventing the syndrome of the trephined, and a potential reduction in axonal stretching.
The bone plate is re-attached via multiple loosely affixed vicryl sutures, enabling decompression, but then ensuring the bone returns to its anatomical position once cerebral edema has subsided.
From the analysis of 57 consecutive patients analyzed at our institution, we have found that the floating anchored craniotomy is comparable to decompressive craniectomy for intracranial pressure reduction and has some significant theoretical advantages.
Despite the potential advantages of techniques that avoid the need for a second cranioplasty, they have not been widely adopted and have been omitted from trials examining the utility of decompressive surgery. This retrospective analysis of prospectively collected data suggests that the floating anchored craniotomy may be applicable instead of decompressive craniectomy.
“浮动锚定”开颅术是我们三级神经外科机构所采用的一种技术，其中传统的减压性颅骨切除术已被浮动开颅术所取代。该技术的假设优势包括充分减压、降低颅内压、无需二次颅骨成形术、维持骨保护、预防颅骨钻孔综合征以及可能减少轴突拉伸。
通过多条松散固定的聚乙醇酸缝线重新固定骨板，实现减压，然后在脑水肿消退后确保骨回到其解剖位置。
通过对我们机构连续57例患者的分析，我们发现浮动锚定开颅术在降低颅内压方面与减压性颅骨切除术相当，并且具有一些显著的理论优势。
尽管避免二次颅骨成形术的技术具有潜在优势，但它们尚未被广泛采用，并且在检验减压手术效用的试验中被省略。这项对前瞻性收集数据的回顾性分析表明，浮动锚定开颅术可能适用于替代减压性颅骨切除术。
