Isolated Effects of Bone, Spring and Surgical Parameters on the Surgical Outcome in Spring-Assisted Sagittal Synostosis Correction.

Sagittal synostosis can be corrected using spring-assisted cranioplasty which, involves removing bony parts from the skull and inserting compressed springs to expand the skull. However, surgical outcomes in spring-assisted cranioplasty may remain suboptimal due to the interacting effects of skull, and spring parameters and surgical settings. Therefore, understanding the effects of skull and spring parameters, and surgical settings, on surgical outcomes is crucial to improving spring-assisted cranioplasty. The aim of this study is to evaluate the isolated effects of calvarial bone and spring parameters and surgical settings on the surgical outcome in the correction of sagittal synostosis with spring-assisted cranioplasty. A 3D parametric skull model with sagittal synostosis was used to simulate spring-assisted cranioplasty. Computational simulations were used to simulate the effects of spring, surgical, and skull parameters. Results showed that relatively low elastic modulus and thickness in the calvarial bones had remarkable effects on surgical outcomes in sagittal synostosis after spring-assisted cranioplasty. However, after spring-assisted cranioplasty, the post-operative cranial index increased a little for higher elastic modulus and thickness in the calvarial bones. Therefore, evaluating the mechanical and geometric properties of the skull during surgical planning may ensure successful surgical outcomes in sagittal synostosis treated with spring-assisted cranioplasty.