title: Low Incidence of Bone Flap Resorption After Native Bone Cranioplasty in Adults.
abstract: OBJECTIVE
  Cranioplasty via use of the patient's autologous bone is performed often after craniectomy procedures. Bone resorption remains a matter of concern in patients with native bone cranioplasty. The objective of this study was to evaluate the rate of native bone resorption in adults and review associated factors that may increase the risk of resorption.
  
  
  METHODS
  This is a single-center retrospective cohort study that assessed consecutive patients who had cranioplasty via use of the patient's native bone flap. A total of 114 patients were identified. Electronic medical records were reviewed for demographic and operative data.
  
  
  RESULTS
  The mean age was 51.2 years. The main indications for initial craniectomy included subarachnoid hemorrhage (SAH) in 50.9%, intracerebral hemorrhage in 17.5%, ischemic stroke in 14.9%, and trauma in 13.2% of patients. Mean interval between craniectomy and cranioplasty was 6 months. Mean follow-up after cranioplasty was 25 months. Bone resorption occurred in 3 patients (2.7%): at 6 months in a 30-year-old woman who presented with SAH followed by decompressive craniectomy and cranioplasty 3.5 months later; at 19 months in a 67-year-old female patient who presented with intracerebral hemorrhage followed by decompressive craniectomy and cranioplasty 6 months later; and at 9 months in a 50-year-old man who presented with SAH followed by craniectomy for clip ligation and cranioplasty 3 months later. Two of these patients underwent replacement of the native flap with synthetic material.
  
  
  CONCLUSIONS
  The rate of autologous bone flap resorption in adult patients undergoing cranioplasty is low even after a mean interval for cranioplasty of 6 months.
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors.forename: Badih
authors.initials: B
authors.lastname: Daou
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Zanaty
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Dalyai
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Rosenwasser
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA. Electronic address: stavropoula.tjoumakaris@jefferson.edu.
authors.forename: Stavropoula
authors.initials: S
authors.lastname: Tjoumakaris
mesh_terms: D000328:Adult; D000368:Aged; D001862:Bone Resorption / Q000453:epidemiology* / Q000209:etiology*; D015331:Cohort Studies; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012886:Skull / Q000601:surgery; D013524:Surgical Flaps / Q000009:adverse effects*; D015898:Tomography Scanners, X-Ray Computed
keywords: Autologous bone; Cranioplasty; Resorption