Wake Forest University School of Medicine, Winston-Salem.
Cone Health, Greensboro, NC.
J Craniofac Surg. 2021;32(1):164-167. doi: 10.1097/SCS.0000000000007096.
Craniosynostosis (CSS), the premature fusion of calvarial sutures, most commonly involves the sagittal suture. Cranial vault remodeling (CVR) is a traditional method of CSS correction. Minimally invasive methods are becoming widely accepted, including spring-assisted surgery (SAS). The equipment required for SAS is minimal therefore adaptable to resource challenged health systems. This paper outlines the experience of SAS in Moldova.A retrospective study was performed for patients treated with SAS for sagittal CSS from 2011 to 2018 in Moldova. Perioperative data were recorded including age, length of surgery, blood loss, volume transfused and length of stay. Four patients had pre- and post-operative computed tomography (CT) scans which were used to calculate changes in cephalic index, normative cephalic index, and intracranial volume.Thirteen patients underwent SAS. Diagnoses were made clinically and confirmed with CT. Mean age at surgery was 4.0 months, and length of surgery 62.7 minutes. All but one patient received a blood transfusion, as is standard of practice in Moldova. The mean length of post-operative recovery in ICU was 30.9 hours. No complications required surgical revision. Springs were removed after 4 to 5 months. All patients had a subjective improvement in scaphocephaly. Based on the available CT scans, an increase in cephalic index (7.3%), normative cephalic index (11.8%), and intracranial volume (38.1%) was observed. One patient underwent SAS at 11 months and required cranioplasty for asymmetry at the time of spring removal.SAS is a safe and cost-effective method of CSS correction that can be utilized in countries with limited health system resources.
颅缝早闭（CSS）是颅骨缝线过早融合，最常见于矢状缝。颅穹窿重塑（CVR）是 CSS 矫正的传统方法。微创方法越来越被广泛接受，包括弹簧辅助手术（SAS）。SAS 需要的设备最少，因此适应资源有限的卫生系统。本文概述了摩尔多瓦 SAS 的经验。对 2011 年至 2018 年期间在摩尔多瓦接受 SAS 治疗矢状 CSS 的患者进行了回顾性研究。记录了围手术期数据，包括年龄、手术时间、失血量、输血量和住院时间。有 4 名患者接受了术前和术后的计算机断层扫描（CT）检查，用于计算头颅指数、正常头颅指数和颅内体积的变化。13 名患者接受了 SAS。通过临床诊断，并通过 CT 证实。手术时的平均年龄为 4.0 个月，手术时间为 62.7 分钟。除 1 名患者外，所有患者均输血，这是摩尔多瓦的标准做法。在 ICU 中术后恢复的平均时间为 30.9 小时。没有并发症需要手术修正。弹簧在 4 至 5 个月后取出。所有患者的斜头畸形都有主观改善。根据现有的 CT 扫描，观察到头骨指数（7.3%）、正常头颅指数（11.8%）和颅内体积（38.1%）增加。1 名患者在 11 个月时接受了 SAS，在弹簧取出时因不对称而需要颅骨成形术。SAS 是一种安全且具有成本效益的 CSS 矫正方法，可用于资源有限的卫生系统国家。
