{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:57:11Z","timestamp":1790776631520,"version":"4.1.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Objective<\/jats:title>\n To evaluate the incidence and characteristics of secondary synostosis following spring-mediated cranioplasty (SMC) for nonsyndromic sagittal craniosynostosis.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Single tertiary pediatric hospital.<\/jats:p>\n <\/jats:sec>\n \n Patients\/Participants<\/jats:title>\n Ten patients with isolated sagittal craniosynostosis who underwent primary SMC between 2021 and 2023. Patients with syndromic diagnoses or prior cranial surgery were excluded.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n SMC was performed using 2 to 3 stainless-steel springs following sagittal strip craniectomy. Springs were typically removed 3 to 4 months postoperatively. Follow-up included review of clinical photographs, radiographs, and operative records.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Change in cephalic index (CI) from preoperative to postoperative assessment and occurrence of secondary suture fusion, particularly coronal synostosis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Mean age at surgery was 4 months (range, 3-6 months). Mean CI improved from 68.5 to 79 following expansion. Three patients (30%) developed left unicoronal synostosis (UCS) during the perioperative period prior to spring removal. One patient required secondary coronal suturectomy for significant frontal asymmetry, while 2 were observed without intervention.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Secondary synostosis, particularly UCS, may represent an underrecognized sequela of SMC. Altered biomechanical forces or asymmetric cranial remodeling during distraction may contribute to this finding. Larger, multicenter studies with longitudinal imaging are warranted to determine incidence, risk factors, and preventive strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10556656251405356","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T14:49:51Z","timestamp":1765205391000},"page":"2989-2995","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary Synostosis After Spring-Mediated Cranioplasty for Sagittal Synostosis"],"prefix":"10.1177","volume":"63","author":[{"given":"Max","family":"Shrout","sequence":"first","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1716-8705","authenticated-orcid":false,"given":"Trey D.","family":"Watmore","sequence":"additional","affiliation":[{"name":"Phoenix Children's"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1030-0798","authenticated-orcid":false,"given":"Alma","family":"Jukic","sequence":"additional","affiliation":[{"name":"University of Arizona College of Medicine-Phoenix"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4982-1405","authenticated-orcid":false,"given":"Davinder J.","family":"Singh","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"Phoenix Children's"},{"name":"Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.32208"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19960329)62:3<282::AID-AJMG15>3.0.CO;2-G"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.08.026"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3171\/2014.2"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3109\/2000656X.2014.981268"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003465"},{"key":"e_1_3_2_8_2","unstructured":"Fischer S. Sagittal synostosis - Surgical outcomes and long-term follow up. 2021. Accessed February 9 2025. https:\/\/gupea.ub.gu.se\/handle\/2077\/69309"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000007168"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3182a75102"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001186"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1993_030_0401_ioofc_2.3.co_2"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221088743"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181954ce3"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-024-06531-4"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181d0abcf"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181d0abb4"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","unstructured":"Arko L Swanson JW Fierst TM Henn RE Chang D Storm PB Bartlett SP Taylor JA Heuer GG. Spring-mediated sagittal craniosynostosis treatment at the Children\u2019s Hospital of Philadelphia: technical notes and literature review. Published online May 1 2015. doi:10.3171\/2015.3. 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