Ultrasound-aided fixation of a biodegradable cranial fixation system: uses in pediatric neurosurgery.
OBJECTIVE
Bioresorbable implant systems have been used in neurosurgery for the rigid fixation of cranial and facial bones. A relatively recent advancement has been the fixation of these implants using an ultrasonic device. The experience with such a device in neurosurgical practice has been limited. The authors report on their experience with ultrasound-aided fixation of bioresorbable implants in pediatric neurosurgical practice.


METHODS
The study consisted of 2 parts. The retrospective portion consisted of a chart review of pertinent clinical information, complications, and outcomes after the use of a commercially available ultrasound-aided bioresorbable implant system (SonicWeld Rx, KLS Martin L.P.). Follow-up was obtained in all patients via clinical examination or telephone interview. The prospective portion of the study consisted of video analysis of the implantation technique in a routine craniotomy. Implantation times were measured, and delays during treatment were noted.


RESULTS
Over a period of 2 years, 28 consecutive patients underwent placement of these implants for bone fixation during craniotomies or craniofacial reconstructions. The only complication was seen in a child with Crouzon syndrome, who had a wound infection caused by Serratia sepsis from a central venous line infection. There were no repeated operations for implant-related swelling, and no cases of premature plate resorption, bone instability, or settling. In vivo, the average time required to implant a resorbable pin with this system was 22 seconds.


CONCLUSIONS
The use of a bioresorbable implant system with ultrasound-aided pin fixation in pediatric neurosurgery cases achieved adequate stability with few complications. This system was easy to use and provided rapid fixation of implants.
Aldana
Philipp R
PR
Division of Pediatric Neurosurgery, University of Florida Health Sciences Center Jacksonville/Wolfson Children's Hospital, Jacksonville, FL, USA. philipp.aldana@jax.ufl.edu
Roy
Saswata
S
Postlethwait
Richard A
RA
James
Hector E
HE
D020341:Absorbable Implants; D000293:Adolescent; D002648:Child; D003399:Craniotomy / Q000295:instrumentation* / Q000379:methods; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008499:Medical Records; D009493:Neurosurgery / Q000295:instrumentation*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D014465:Ultrasonics; D014463:Ultrasonography