SynthesisActa neurochirurgica2022
Complications and cosmetic outcomes of materials used in cranioplasty following decompressive craniectomy-a systematic review, pairwise meta-analysis, and network meta-analysis.
Synthesis in Acta neurochirurgica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- The role of autologous bone in cranioplasty. A systematic review of complications and risk factors by using stored bone.Acta neurochirurgica · 2024Pooled it
- Material type versus defect size in adult cranioplasty: a multi-institutional analysis of 30-day outcomes and risk prediction modeling.JPRAS open · 2026Article
- The cranioplasty equation: the influence of biomaterials, surgical timing, and frailty on optimising success.Neurosurgical review · 2026Article
- Polyetheretherketone (PEEK) in Cranial Vault Reconstruction: A Review of Alloplastic Materials, Clinical Performance, and Institutional Experience.Bioengineering (Basel, Switzerland) · 2026Article
- The Importance of Plastic Surgery in Multidisciplinary Teams: A Systematic Review and Meta-analysis of Comparative Studies.Plastic and reconstructive surgery. Global open · 2026Article
- Optimal time between decompressive craniectomy and cranioplasty to reduce the risk of complications: A retrospective study.Neurosurgical review · 2026Article
- Autologous bone flap salvage strategies in postcraniotomy surgical site infections: A scoping review.Surgical neurology international · 2026Review
- Autologous skull graft resorption following cranioplasty: a case report and literature review.Frontiers in surgery · 2026Article
- Comparison of autologous and custom-made titanium cranioplasty following decompressive craniectomy for traumatic brain injury: A 7-year clinical experience.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2025Article
- Outcomes and Workflow in a Titanium Powder Bed Fusion Cranial Reparation Surgery Service.3D printing and additive manufacturing · 2025Article
- Volumetric changes in the bone flap at one year follow up in patients undergoing craniotomy.Neurosurgical review · 2025Article
- Article
- Early osteointegration in "one-step" resection and reconstruction using porous hydroxyapatite custom implants for skull-infiltrating tumors: a monocentric prospective series.Acta neurochirurgica · 2024Article
- Challenging frontiers in neuroplastic cranial reconstruction: addressing neurosurgical wound healing complications through interdisciplinary collaboration - an observational study.Acta neurochirurgica · 2024Observational
- Complication rates after autologous cranioplasty following decompressive craniectomy.Acta neurochirurgica · 2024Article
- Cranial stair-step incision for minimizing postoperative complications in neuro-oncologic surgery: A propensity score-matched analysis.Acta neurochirurgica · 2024Article
- Transcriptomic and cellular decoding of scaffolds-induced suture mesenchyme regeneration.International journal of oral science · 2024Article
- Exploring complications following cranioplasty after decompressive hemicraniectomy: A retrospective bicenter assessment of autologous, PMMA and CAD implants.Neurosurgical review · 2024Observational
- Explanted Skull Flaps after Decompressive Hemicraniectomy Demonstrate Relevant Bone Avitality-Is Their Reimplantation Worth the Risk?Brain sciences · 2023Article
- Bespoke Implants for Cranial Reconstructions: Preoperative to Postoperative Surgery Management System.Bioengineering (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOptimal reconstruction materials for cranioplasty following decompressive craniectomy (DC) remain unclear. This systematic review, pairwise meta-analysis, and network meta-analysis compares cosmetic outcomes and complications of autologous bone grafts and alloplasts used for cranioplasty following DC.
methodPubMed, Embase, and Cochrane were searched from inception until April 2021. A random-effects pairwise meta-analysis was used to compare pooled outcomes and 95% confidence intervals (CIs) of autologous bone to combined alloplasts. A frequentist network meta-analysis was subsequently conducted to compare multiple individual materials.
resultsOf 2033 articles screened, 30 studies were included, consisting of 29 observational studies and one randomized control trial. Overall complications were statistically significantly higher for autologous bone compared to combined alloplasts (RR = 1.56, 95%CI = 1.14-2.13), hydroxyapatite (RR = 2.60, 95%CI = 1.17-5.78), polymethylmethacrylate (RR = 1.50 95%CI = 1.08-2.08), and titanium (Ti) (RR = 1.56 95%CI = 1.03-2.37). Resorption occurred only in autologous bone (15.1%) and not in alloplasts (0.0%). When resorption was not considered, there was no difference in overall complications between autologous bone and combined alloplasts (RR = 1.00, 95%CI = 0.75-1.34), nor between any individual materials. Dehiscence was lower for autologous bone compared to combined alloplasts (RR = 0.39, 95%CI = 0.19-0.79) and Ti (RR = 0.34, 95%CI = 0.15-0.76). There was no difference between autologous bone and combined alloplasts with respect to infection (RR = 0.85, 95%CI = 0.56-1.30), migration (RR = 1.36, 95%CI = 0.63-2.93), hematoma (RR = 0.98, 95%CI = 0.53-1.79), seizures (RR = 0.83, 95%CI = 0.29-2.35), satisfactory cosmesis (RR = 0.88, 95%CI = 0.71-1.08), and reoperation (RR = 1.66, 95%CI = 0.90-3.08).
conclusionsBone resorption is only a consideration in autologous cranioplasty compared to bone substitutes explaining higher complications for autologous bone. Dehiscence is higher in alloplasts, particularly in Ti, compared to autologous bone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.