ArticleActa neurochirurgica2019
Classification of bone flap resorption after cranioplasty: a proposal for a computed tomography-based scoring system.
Article in Acta neurochirurgica, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Bone flap resorption and its risk factors following autologous cranioplasty with bone tissue bank-stored grafts.Neurosurgical review · 2026Article
- Imaging approach to pediatric calvarial bulges.Pediatric radiology · 2024Review
- Cranial Repair in Children: Techniques, Materials, and Peculiar Issues.Advances and technical standards in neurosurgery · 2024Review
- Facial Gender-Affirming Surgery: Frontal Bossing Surgical Techniques, Outcomes and Safety.Aesthetic plastic surgery · 2023Article
- Acceptable durability of split inner table graft for the reconstruction of a bone defect in pterional craniotomies: a case series.Frontiers in surgery · 2023Article
- Favourable long-term recovery after decompressive craniectomy: the Northern Finland experience with a predominantly adolescent patient cohort.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Article
- Protocol for the multicentre prospective paediatric craniectomy and cranioplasty registry (pedCCR) under the auspices of the European Society for Paediatric Neurosurgery (ESPN).Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Article
- Sinking skin flap syndrome in a patient with bone resorption after cranioplasty and ventriculoperitoneal shunt placement: illustrative case.Journal of neurosurgery. Case lessons · 2021Article
- Bone Flap Resorption in Pediatric Patients Following Autologous Cranioplasty.Operative neurosurgery (Hagerstown, Md.) · 2021Review
- Safety, Feasibility, and Patient-Rated Outcome of Sonolucent Cranioplasty in Extracranial-Intracranial Bypass Surgery to Allow for Transcranioplasty Ultrasound Assessment.World neurosurgery · 2020Article
- From decompressive craniectomy to cranioplasty and beyond-a pediatric neurosurgery perspective.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2019Article
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7 authors.
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Abstract
backgroundBone flap resorption (BFR) is the most prevalent complication resulting in autologous cranioplasty failure, but no consensus on the definition of BFR or between the radiological signs and relevance of BFR has been established. We set out to develop an easy-to-use scoring system intended to standardize the interpretation of radiological BFR findings.
methodsAll 45 autologous cranioplasty patients operated on at Oulu University Hospital from 2004 to 2014 were identified, and the bone flap status of all the available patients was evaluated using the new scoring system. Derived from previous literature, a three-variable score for the detection of BFR changes is proposed. The variables "Extent" (estimated remaining bone volume), "Severity" (possible perforations and their measured diameter), and "Focus" (the number of BFR foci within the flap) are scored from 0 to 3 individually. Using the sum of these scores, a score of 0-9 is assigned to describe the degree of BFR. Additionally, independent neurosurgeons assessed the presence and relevance of BFR from the same data set. These assessments were compared to the BFR scores in order to find a score limit for relevant BFR.
resultsBFR was considered relevant by the neurosurgeons in 11 (26.8%) cases. The agreement on the relevance of BFR demonstrated substantial strength (κ 0.64, 95%CI 0.36 to 0.91). The minimum resorption score in cases of relevant BFR was 5. Thus, BFR with a resorption score ≥ 5 was defined relevant (grades II and III). With this definition, grade II or III BFR was found in 15 (36.6%) of our patients. No risk factors were found to predict relevant BFR.
conclusionsThe score was proven to be easy to use and we recommend that only cases with grades II and III BFR undergo neurosurgical consultation. However, general applicability can only be claimed after validation in independent cohorts.
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