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Cryopreserved Autogenous Cranioplasty: A Systematic Review and Meta-Analysis of Factors Associated with Severe Bone Resorption
Jude Kluemper, BS
Emily Pfahl, BS
Abdulaziz Elemosho, MD
Kerry-Ann S. Mitchell, MD PhD
The Ohio State University College of Medicine
2024-01-15
Presenter: Jude Kluemper
Affidavit:
I certify that the work presented here is the original work of Jude Kluemper and members of the Mitchell lab. This work has not been presented at another major meeting.
Director Name: Gregory Pearson
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction:
Cryopreserved autogenous cranioplasty (AC) is often performed by plastic surgeons and neurosurgeons following a decompressive craniectomy. AC is associated with many complications including bone flap resorption (BFR). Previous meta-analyses have attempted to investigate various factors that contribute to BFR. However, these analyses are limited by varying definitions of BFR and varying methods of bone flap preservation across different studies.
Methods:
A literature search was performed across 4 databases (PubMed, Scopus, Web of Science, Embase). A total of 1085 papers were screened. Studies with the same definition of BFR (resorption requiring reoperation) and the same calvarial bone storage method (cryopreservation) were included.
Results:
Of the 1085 studies screened, 7 have met inclusion criteria for preliminary analysis which includes a total of 1650 patients. Preliminary results indicate patients with resorption were significantly younger (WMD = -8.38, p = <0.001). Calvarial bone flap fragmentation also caused significant increases in BFR (logOR = 1.57, p = <0.001). Patient sex did not significantly impact resorption (logOR -0.13, p = 0.36). Interval between craniectomy and cranioplasty also did not significantly impact resorption rates (WMD = 1.37, p = 0.82). Finally, presence of a ventriculoperitoneal (VP) shunt wasn't associated with an increased risk of resorption (logOR = 0.08, p=0.80).
Conclusion:
These results demonstrate certain factors such as age and bone flap fragmentation may impact incidence of calvarial bone resorption and need for re-operation. The results of this focused meta-analysis should provide new insight into factors affecting severe calvarial bone resorption and lead to improved patient outcomes.
