Louie Christopher E, Hong Jennifer, Bauer David F
1Geisel School of Medicine at Dartmouth, Hanover; and.
2Department of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
J Neurosurg Pediatr. 2019 Mar 29;23(6):704-707. doi: 10.3171/2019.1.PEDS18680. Print 2019 Jun 1.
Suboccipital craniectomy with duraplasty is a commonly performed procedure for children with symptomatic Chiari malformation type I (CM-I). Several dural substitutes are used for duraplasty, ranging from pericranium to synthetic materials. When available, autologous pericranium is often preferred due to its low cost, performance in obtaining a watertight closure, ease of suturing, and absence of immune reaction. Long-term follow-up data on the durability of various dural substitutes are lacking. The authors report a rare, long-term complication of duraplasty performed using an autologous pericranial graft, and they conduct a literature review of similar complications. Heterotopic ossification of an autologous pericranial graft is a rare complication of duraplasty. This dystrophic bone growth can be symptomatic due to compression of neural structures, and it requires reoperation for removal. Surgeons should consider this rare long-term complication in patients presenting with unusual symptoms after duraplasty with pericranium.
枕下颅骨切除术联合硬脑膜成形术是治疗有症状的Ⅰ型 Chiari 畸形（CM-I）患儿的常用手术。硬脑膜成形术使用多种硬脑膜替代物，从颅骨膜到合成材料不等。如有可用的自体颅骨膜，因其成本低、能实现水密性闭合、易于缝合且无免疫反应，常被优先选用。目前缺乏关于各种硬脑膜替代物耐久性的长期随访数据。作者报告了一例使用自体颅骨膜移植进行硬脑膜成形术的罕见长期并发症，并对类似并发症进行了文献综述。自体颅骨膜移植的异位骨化是硬脑膜成形术的一种罕见并发症。这种营养不良性骨生长可能因神经结构受压而出现症状，需要再次手术切除。对于接受颅骨膜硬脑膜成形术后出现异常症状的患者，外科医生应考虑这种罕见的长期并发症。
