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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Polymethylmethacrylate patient matched implants (PMMA-PMI) for complex and revision cranioplasty – analysis of long-term complication rates and patient outcomes

Patientenspezifische Implantate aus Polymethylmethacrylat für komplexe kranioplastische Deckungen und Revisionsoperationen – Langzeitanalyse von Komplikationsraten und Patientenoutcome

Meeting Abstract

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  • presenting/speaker Henrik Giese - Uniklinik Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Jennifer Meyer - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland
  • Andreas W. Unterberg - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland
  • Christopher Beynon - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP221

doi: 10.3205/19dgnc556, urn:nbn:de:0183-19dgnc5564

Veröffentlicht: 8. Mai 2019

© 2019 Giese et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Cranioplasty (CP) is associated with high complication rates. Patient matched implants (PMI) are frequently used for CP. However, only limited data are available regarding complication rates of PMI-based CP after complex or failed primary CP. Here we report our experiences with the use of polymethylmethacrylate (PMMA) PMI.

Methods: We retrospectively analysed the medical records of patients with complex or failed primary CP and subsequent implantation of PMMA-PMI between 2010 and 2015 at our institution. We analysed demographic data, initial clinical diagnosis and surgery-associated complications. Furthermore, we studied the neurological outcome (mRs), quality of life (SF36, EQ5D) and cosmetic results in a prospective evaluation.

Results: A total of 67 patients (29 females, 38 males) with a mean age of 43 years (range: 13–74 years) were included in the study. Primary PMI-CP was performed in 18 patients with destructive or osteolytic bone tumours. Secondary PMI-CP was performed in 49 patients. Complications occurred in 14 patients with an overall complication rate of 21.7% during a mean follow-up of 39.7±23.4 month. Approximately two-thirds of the patients reported a good quality of life after initial event and subsequent CP. 75% of patients showed a good neurological outcome (mRs of 0 to 3) and the majority (>90%) was satisfied with the cosmetic result.

Conclusion: Surgical CP with PMMA-PMI seems to represent a suitable method for patients with failed or complex CP. Complication rates are comparable to those reported for primary CP.