Artikel
Does the duration of cryopreservation impact the morphology of the bone flaps? Computed tomography densitometry analysis of bone flap density in 158 patients
Beeinflusst die Dauer der Kryokonservierung die Knochenstruktur von Knochendeckeln – computertomographische Analyse der Dichte von 158 Knochendeckeln mittels Densitometrie
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Autoren
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Felix Kiepe
- Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
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Philipp Ertl
- Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
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Paul Bronzlik
- Medizinische Hochschule Hannover, Neuroradiology, Hannover, Deutschland
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Joachim Kurt Krauss
- Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
| Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: Decompressive craniectomy (DCE) is a well-established surgical treatment for refractory intracranial hypertension, usually followed by autologous cranioplasty. Autologous bone flaps therefore are stored with cryoconservation (CC) for several months until cranioplasty can be performed. Bone flap resorption is a common problem after cranioplasty leading to disfigurement and protection loss of the brain, requiring further surgical treament. Here, we investigate the density of cryoconserved bone flaps by CT scanning after different periods of CC to identify the impact of storage duration on bone structure.
Methods: Over a 7-year period, bone flaps from 158 patients were preserved postmortem via CC. We performed thin slice CT densitometry and measured the bone mineral density (BMD) in Hounsfield units (HU) at multiple locations of cortical bone and spongiosa.
Results: According to the duration of CC 7 groups (from 1 year to 7 years of CC) were defined. There were no significant differences in BMD values of cortical bone or spongiosa among or within the groups. Both bone structures showed a physiological density, the mean density of the bone flaps was as followes (in HU): 1801,8 cortical/ 365,4 spongiosa (1 year); 1632/ 613 (2 years); 1632/ 522 (3 years); 1473,3/ 772,1 (4 years); 1303/606,3 (5 years); 1605/ 562,5 (6 years); 1640,9/ 510,5 (7 years).
Conclusion: In this series, there was no significant difference in the density of the bone groups associated with duration of CP. CT densitometry therefore cannot predict bone resorption after cranioplasty.
