Shie Caroline S M, Antony Dawn, Thien Ady
Department of Neurosurgery, Brunei Neuroscience, Stroke and Rehabilitation Centre, Pantai Jerudong Specialist Centre, Jerudong, Brunei Darussalam.
Asian J Neurosurg. 2022 Sep 1;17(3):423-428. doi: 10.1055/s-0042-1751007. eCollection 2022 Sep.
Cranioplasty, commonly performed after decompressive craniectomy, is associated with significant complications. We aim to characterize the outcomes and complications post cranioplasty performed in Brunei Darussalam. We conducted a nationwide retrospective study of the patients who underwent cranioplasty. Patients who underwent cranioplasty by the Neurosurgical Department from January 2014 to June 2019 were included. Patients were excluded if they did not have a minimum of 30-days follow-up or the initial cranioplasty was performed elsewhere. Outcomes including complications post cranioplasty and 30-day and 1-year failure rates were assessed. All statistical analyses were performed with SPSS version 20 (IBM Corporation, Armonk, New York, USA). The χ test, Student's -test, and the Mann-Whitney test were performed for nominal, normally, and non-normally distributed variables, respectively. Multivariate logistic regression was used to assess predictors for complications and cranioplasty failure. Seventy-seven patients with a median age of 48 (interquartile range, 37-61) years were included. Most cranioplasties used autologous bone (70/77, 90.9%). Infection and overall complication rates were 3.9% and 15.6%, respectively. Cranioplasty failure (defined as removal or revision of cranioplasty) rate was 9.1%. Previous cranial site infection post craniectomy was associated with cranioplasty failure (odds ratio: 12.2, 95% confidence interval [1.3, 114.0], =0.028). Cranioplasty is generally associated with significant complications, including reoperation for implant failure. We highlighted that autologous bone cranioplasties can be performed with an acceptable low rate of infection, making it a viable first option for implant material.
颅骨修补术通常在减压性颅骨切除术后进行，会引发严重并发症。我们旨在描述文莱达鲁萨兰国颅骨修补术后的结果及并发症情况。
我们对接受颅骨修补术的患者进行了一项全国性回顾性研究。纳入了2014年1月至2019年6月在神经外科接受颅骨修补术的患者。若患者随访时间不足30天或首次颅骨修补术在其他地方进行，则将其排除。评估了颅骨修补术后的并发症及30天和1年的失败率等结果。所有统计分析均使用SPSS 20版软件（美国纽约州阿蒙克市IBM公司）。分别对名义变量、正态分布变量和非正态分布变量进行χ²检验、学生t检验和曼-惠特尼U检验。采用多因素逻辑回归评估并发症和颅骨修补术失败的预测因素。
共纳入77例患者，中位年龄为48岁（四分位间距为37 - 61岁）。大多数颅骨修补术使用自体骨（70/77，90.9%）。感染率和总体并发症率分别为3.9%和15.6%。颅骨修补术失败（定义为颅骨修补物移除或翻修）率为9.1%。颅骨切除术后先前颅骨部位感染与颅骨修补术失败相关（比值比：12.2，95%置信区间[1.3, 114.0]，P = 0.028）。
颅骨修补术通常会引发严重并发症，包括因植入物失败而再次手术。我们强调自体骨颅骨修补术可在感染率较低且可接受的情况下进行，使其成为植入材料的可行首选。
