Ultrasound-aided fixation of a biodegradable cranial fixation system: uses in pediatric neurosurgery

J Neurosurg Pediatr. 2009 May;3(5):420-4. doi: 10.3171/2009.2.PEDS08230.

Abstract

Object: Bioresorbable implant systems have been used in neurosurgery for the rigid fixation of cranial and facial bones. A relatively recent advancement has been the fixation of these implants using an ultrasonic device. The experience with such a device in neurosurgical practice has been limited. The authors report on their experience with ultrasound-aided fixation of bioresorbable implants in pediatric neurosurgical practice.

Methods: The study consisted of 2 parts. The retrospective portion consisted of a chart review of pertinent clinical information, complications, and outcomes after the use of a commercially available ultrasound-aided bioresorbable implant system (SonicWeld Rx, KLS Martin L.P.). Follow-up was obtained in all patients via clinical examination or telephone interview. The prospective portion of the study consisted of video analysis of the implantation technique in a routine craniotomy. Implantation times were measured, and delays during treatment were noted.

Results: Over a period of 2 years, 28 consecutive patients underwent placement of these implants for bone fixation during craniotomies or craniofacial reconstructions. The only complication was seen in a child with Crouzon syndrome, who had a wound infection caused by Serratia sepsis from a central venous line infection. There were no repeated operations for implant-related swelling, and no cases of premature plate resorption, bone instability, or settling. In vivo, the average time required to implant a resorbable pin with this system was 22 seconds.

Conclusions: The use of a bioresorbable implant system with ultrasound-aided pin fixation in pediatric neurosurgery cases achieved adequate stability with few complications. This system was easy to use and provided rapid fixation of implants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorbable Implants*
  • Adolescent
  • Child
  • Craniotomy / instrumentation*
  • Craniotomy / methods
  • Facial Bones / diagnostic imaging
  • Facial Bones / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Internal Fixators*
  • Male
  • Medical Records
  • Neurosurgery / instrumentation*
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods*
  • Plastic Surgery Procedures / instrumentation
  • Plastic Surgery Procedures / methods
  • Prospective Studies
  • Prosthesis Implantation / methods*
  • Retrospective Studies
  • Skull / diagnostic imaging
  • Skull / surgery
  • Treatment Outcome
  • Ultrasonics*
  • Ultrasonography