{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:21:03Z","timestamp":1790299263226,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10]]},"abstract":"\n Background:<\/jats:title>\n Spring-assisted surgery is an accepted alternative to cranial vault remodeling for treatment of sagittal craniosynostosis. The long-term safety and efficacy profiles of spring-assisted surgery have not been established.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This study is a retrospective examination of all patients treated with spring-assisted surgery (\n n<\/jats:italic>\n = 175) or cranial vault remodeling (\n n<\/jats:italic>\n = 50) for sagittal craniosynostosis at the authors\u2019 institution from 2003 to 2017. Data collected included demographic and operative parameters, preoperative and postoperative Cephalic Indices, and complications. Whitaker grades were assigned blindly by a craniofacial surgeon not involved in patients\u2019 care.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The mean age at surgery was significantly lower for the spring-assisted surgery group compared with the cranial vault remodeling group (4.6 months versus 22.2 months;\n p<\/jats:italic>\n < 0.001). Even when combining spring placement with spring removal operations, total surgical time (71.1 minutes versus 173.5 minutes), blood loss (25.0 ml versus 111.2 ml), and hospital stays (41.5 hours versus 90.0 hours) were significantly lower for the spring-assisted surgery cohort versus the cranial vault remodeling group (\n p<\/jats:italic>\n < 0.001 for all). There were no differences in infection, reoperation rate, or headaches between the groups. The percentage improvement in Cephalic Index was not significantly different at 1 (\n p<\/jats:italic>\n = 0.13), 2 (\n p<\/jats:italic>\n = 0.99), and 6 (\n p<\/jats:italic>\n = 0.86) years postoperatively. At 12 years postoperatively, the spring-assisted surgery group had persistently improved Cephalic Index (75.7 preoperatively versus 70.7 preoperatively). Those undergoing spring-assisted surgery had significantly better Whitaker scores, indicating less need for revision surgery, compared with the cranial vault remodeling group (\n p<\/jats:italic>\n = 0.006).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Compared with the authors\u2019 cranial vault remodeling technique, spring-assisted surgery requires less operating room time and is associated with less blood loss, but it has equivalent long-term Cephalic Indices and subjectively better shape outcomes.<\/jats:p>\n <\/jats:sec>\n \n CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title>\n Therapeutic, III.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/prs.0000000000007168","type":"journal-article","created":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T05:20:58Z","timestamp":1593235258000},"page":"833-841","source":"Crossref","is-referenced-by-count":51,"title":["Long-Term Outcomes of Spring-Assisted Surgery for Sagittal Craniosynostosis"],"prefix":"10.1097","volume":"146","author":[{"given":"Christopher M.","family":"Runyan","sequence":"first","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle S.","family":"Gabrick","sequence":"additional","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jungwon G.","family":"Park","sequence":"additional","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Massary","sequence":"additional","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kshipra","family":"Hemal","sequence":"additional","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth S.","family":"Owens","sequence":"additional","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T.","family":"Thompson","sequence":"additional","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Couture","sequence":"additional","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa R.","family":"David","sequence":"additional","affiliation":[{"name":"From the Departments of Plastic and Reconstructive Surgery and Neurosurgery, Wake Forest School of Medicine; the Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; and the Department of Surgery, Division of Plastic Surgery, Carilion Clinic."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6,25]]},"reference":[{"key":"R1-20231109","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1002\/uog.91","article-title":"Prenatal ultrasound diagnosis of fetal craniosynostosis.","volume":"21","author":"Delahaye","year":"2003","journal-title":"Ultrasound Obstet Gynecol"},{"key":"R2-20231109","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/SCS.0000000000004040","article-title":"The etiology of neuronal development in craniosynostosis: A working hypothesis.","volume":"29","author":"Brooks","year":"2018","journal-title":"J Craniofac Surg"},{"key":"R3-20231109","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1097\/PRS.0000000000000420","article-title":"The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal 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effects.","volume":"87","author":"Persing","year":"1991","journal-title":"Plast Reconstr Surg"},{"key":"R11-20231109","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/00006534-198611000-00006","article-title":"Skull expansion in experimental craniosynostosis.","volume":"78","author":"Persing","year":"1986","journal-title":"Plast Reconstr Surg"},{"key":"R12-20231109","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1080\/02844319850158697","article-title":"Spring mediated dynamic craniofacial reshaping: Case report.","volume":"32","author":"Lauritzen","year":"1998","journal-title":"Scand J Plast Reconstr Surg Hand Surg"},{"key":"R13-20231109","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/PRS.0000000000004037","article-title":"Minimally invasive, spring-assisted correction of sagittal suture synostosis: Technique, outcome, and complications in 83 cases.","volume":"141","author":"van Veelen","year":"2018","journal-title":"Plast Reconstr 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