gms | German Medical Science

Objective: Computer assisted designed (CAD) implants made of titanium, ceramic (Bioverit^®) and peek have become more and more popular in the treatment of large skull defects. But nevertheless there is still a considerable complication rate reported in these patients. With our data now we want to present possible short- and long-term complications after skull remodeling using a CAD allograft in one of the – up to now – largest patient series.

Method: We retrospectively analyzed all consecutive patients receiving an allograft from 9/1994 to 2/2013 in our department. We created a data set including age, gender, indication and material using SPSS 21 to define possible risk factors for a postoperative complication.

Results: The patient cohort comprises 124 patients with 128 implants. Mean age was 43.5 ± 20.4 years with a men/ female ratio of 74 : 50. 82 titanium (64.1%), 27 peek (21.1%) and 19 ceramic grafts (14.8%) were implanted. Most common reason for an implantation was the aseptic resorption of an autograft reimplanted before in 54 (42.2%) cases. Concerning the complications epi-, sub- or intracerebral bleeding occurred in 9 (7%), a space occupying chronic epi-/ subdural fluid collection in 5 (3.9%), an infection in 11 (8.6%) and a dislocation of the allograft in 2 (1.6%) cases. So the overall complication rate was 21.1% (26 patients). Statistic analysis (Chi square) revealed no significant correlation between complications and age (p=0.721), gender (p=0.059), type of allograft (p=0.621) and indication for surgery (p=0.36).

Conclusions: Our data underline the already reported high complication rate after the implantation of an allograft. A specific risk factor for a postoperative complication could not be determined.