SynthesisActa neurochirurgica2025
Beyond decompression: predictors of cranioplasty failure in pediatric patients - a meta-analysis.
Synthesis in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Severe Craniocerebral Injury in a Child Caused by Repetitive Cleaver Strikes: Case Report and Review of the Literature.Clinical case reports · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPediatric cranioplasty following decompressive craniectomy is associated with high complication rates, particularly bone resorption and infection. Unlike adult populations, children face unique anatomical and physiological challenges, and the lack of viable alternatives to autologous bone graft further complicates outcomes. This meta-analysis aims to evaluate the current state of pediatric cranioplasty, identifying key predictors of bone resorption and infection, and assessing outcomes to guide future clinical improvements.
methodsA systematic search was conducted in MEDLINE/PubMed and Web of Knowledge using combinations of the terms "cranioplasty," "pediatric," "children," and "decompressive craniectomy." Studies were included if they reported quantitative data on outcomes in pediatric populations. Risk of bias were assessed using the ROBINS-I tool.
resultsSeven retrospective case series encompassing 594 patients were analysed. The average age of patients was 8.4 years, with a mean follow-up of 37.8 months. The mean time from craniectomy to cranioplasty was 12.5 weeks. Autologous bone graft was used in 77.6% of cases. The rate of bone resorption requiring reoperation approached 30%, and infection occurred in approximately 10% of patients. Delayed cranioplasty (> 6 weeks), large skull defect area, underlying cerebral contusion, and comminuted fractures significantly predicted bone graft resorption. The use of ventriculoperitoneal shunts, cranial implants, and non-titanium fixation materials were associated with higher infection and resorption rates.
conclusionPediatric cranioplasty carries unacceptably high complication rates for an elective procedure. Early intervention and the use of titanium fixation may reduce the burden of reoperation. Further prospective studies are necessary to establish standardized surgical protocols and explore alternative materials.
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