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Spring forces and calvarial thickness predict cephalic index changes following spring-mediated cranioplasty for sagittal craniosynostosis

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Abstract

Background

Variables interacting to predict outcomes following spring-mediated cranioplasty (SMC) for non-syndromic craniosynostosis, including spring parameters and calvarial thickness, are poorly understood. This study assessed interactions between spring parameters and calvarial thickness to predict changes in cephalic index (CI) following SMC.

Methods

Patients undergoing SMC for non-syndromic sagittal craniosynostosis at our institution between 2014 and 2021 were included. Calvarial thickness was determined from patient preoperative CTs using Materalise Mimics at 27 points in relation to the sagittal suture. Linear mixed effects models were used to determine interactions between anterior, middle, and posterior calvarial thickness with spring force and length.

Results

Sixty-nine patients undergoing surgery at mean age 3.7 months were included in this study. Stronger posterior spring force interacted with thinner posterior calvarial thickness to predict greater changes in CI at 3 months postoperatively (p = 0.022). When evaluating spring force and calvarial thickness set distances from the sagittal suture, stronger posterior spring force interacted with thinner posterior calvarial thickness 5 mm (p = 0.043) and 10 mm (p = 0.036) from the sagittal suture to predict changes in CI. Interactions between spring parameters and calvarial thickness in the anterior and middle positions did not significantly predict changes in CI.

Conclusions

Stronger posterior spring force interacted with thinner posterior calvaria to predict greater changes in CI 3 months following SMC for non-syndromic sagittal craniosynostosis. These results suggest dynamic interactions between several variables may impact outcomes following SMC.

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Availability of data and material

Data will be published in Child’s Nervous System.

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Funding

This research was funded by the Division of Plastic & Reconstructive Surgery at the Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania.

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Authors and Affiliations

  1. Division of Plastic, Reconstructive and Oral Surgery, Children’s Hospital of Philadelphia, 3501 Civic Center Blvd Philadelphia, Philadelphia, PA, 19104, USA

    Dillan F. Villavisanis, Daniel Y. Cho, Connor S. Wagner, Jessica D. Blum, Sameer Shakir, Jordan W. Swanson, Scott P. Bartlett & Jesse A. Taylor

  2. Center for Data Driven Discovery in Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Chao Zhao

  3. Division of Neurosurgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Alexander M. Tucker

Authors
  1. Dillan F. Villavisanis
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  2. Daniel Y. Cho
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  3. Chao Zhao
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  4. Connor S. Wagner
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  5. Jessica D. Blum
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  6. Sameer Shakir
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  7. Jordan W. Swanson
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  8. Scott P. Bartlett
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  9. Alexander M. Tucker
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  10. Jesse A. Taylor
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Contributions

Dillan Villavisanis, Dr Daniel Cho, Dr Sameer Shakir, Dr Jordan Swanson, Dr Scott Bartlett, Dr Alexamder Tucker, and Dr Jesse Taylor designed the study. Dillan Villavisanis, Dr Daniel Cho, Connor Wagner, Jessica Blum, and Dr Sameer Shakir collected data. Dillan Villavisanis and Chao Zhao completed statistical analysis. Dillan Villavisanis wrote the manuscript. All authors critically appraised and reviewed the manuscript.

Corresponding author

Correspondence to Jesse A. Taylor.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the institutional review board at the Children’s Hospital of Philadelphia.

Consent for publication

All authors consent for publication in Child’s Nervous System.

Conflict of interest

DFV is a fellow and consultant to Artis Ventures, LP. JWS is a consultant to KLS Martin, LP and Synthes, LP. SPB is a co-founder and stakeholder of TalexMedical (InfantEar), LLC. JAT is a co-founder and co-owner of Ostiio, LLC. All other authors declare no competing interests.

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Villavisanis, D.F., Cho, D.Y., Zhao, C. et al. Spring forces and calvarial thickness predict cephalic index changes following spring-mediated cranioplasty for sagittal craniosynostosis. Childs Nerv Syst 39, 701–709 (2023). https://doi.org/10.1007/s00381-022-05752-9

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