{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T08:48:46Z","timestamp":1745311726393},"reference-count":13,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T00:00:00Z","timestamp":1727222400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Background: This study evaluated spring-assisted posterior vault expansion (SA-PVE) in children aged &gt;\u00a02 years with craniosynostosis and signs of high intracranial pressure (ICP).\nMethods: We retrospectively analysed all consecutive patients aged &gt;\u20092 years and operated with SA-PVE\u00a0between 2018 and 2020 at the Craniofacial Center at Sahlgrenska University Hospital, Sweden. During the procedure, a circumferent occipital bone flap extending below the torcula was created and remained attached to the dura. Intracranial volumes (ICVs) were calculated from computed tomography (CT) images, and demographic data and information regarding symptoms and signs of high ICP were collected.\nResults: The study included eight patients [Crouzon\/Pfeiffer (n\u2009=\u20094), multiple craniosynostosis (n\u2009=\u20093), and secondary synostosis (n\u2009=\u20091)]. Median age at SA-PVE was 3.8 years (range: 2.5\u201312.8 years), and springs were removed after a median of 5.5 months (range: 2.3\u20138.3 months). The median operating time\u00a0was\u00a0164\u00a0min (range: 102\u2013221 min), and estimated blood loss was 4.5 mL\/kg body weight (range: 1.4\u201359.1 mL\/kg body weight), with 50% of patients receiving a blood transfusion. The median increase in ICV was 206 cm3 (range: 122\u2013344 cm3) representing an 18.7% increase (range: 7.9\u201324.1%; p\u2009=\u20090.01). We\u00a0observed no major perioperative complications, and symptoms related to high ICP were improved or absent at clinical follow-up.\nConclusion: These results demonstrated that SA-PVE involving creation of a large occipital bone flap\u00a0including the torcula as a safe and effective surgical treatment in children aged &gt;2 years with craniosynostosis and elevated ICP.<\/jats:p>","DOI":"10.2340\/jphs.v59.41906","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T13:32:01Z","timestamp":1727271121000},"page":"117-122","source":"Crossref","is-referenced-by-count":1,"title":["Spring-assisted posterior vault expansion in children over 2 years of age with craniosynostosis"],"prefix":"10.2340","volume":"59","author":[{"given":"Karin","family":"S\u00e4lj\u00f6","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madiha","family":"Bhatti-S\u00f8fteland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Tarnow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Olsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Hall\u00e9n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Chih","family":"Chao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"K\u00f6lby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Maltese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2024,9,25]]},"reference":[{"key":"77774","doi-asserted-by":"crossref","unstructured":"Sgouros S, Goldin J, Hockley A, et al. Posterior skull surgery in craniosynostosis. Childs Nerv Syst. 1996;12:727\u2013733. https:\/\/doi.org\/10.1007\/BF00366158","DOI":"10.1007\/BF00366158"},{"key":"77775","doi-asserted-by":"crossref","unstructured":"White N, Evans M, Dover MS, et al. Posterior calvarial vault expansion using distraction osteogenesis. Childs Nerv Syst. 2009;25:231\u2013236. https:\/\/doi.org\/10.1007\/s00381-008-0758-6","DOI":"10.1007\/s00381-008-0758-6"},{"key":"77776","doi-asserted-by":"crossref","unstructured":"Lauritzen CGK, Davis C, Ivarsson A, et al. The evolving role of springs in craniofacial surgery: the first 100 clinical cases. Plast Reconstr Surg. 2008;121:545\u2013554. https:\/\/doi.org\/10.1097\/01.prs.0000297638.76602.de","DOI":"10.1097\/01.prs.0000297638.76602.de"},{"key":"77777","doi-asserted-by":"crossref","unstructured":"Di Rocco F, Usami K, Protzenko T, et al. Results and limits of posterior cranial vault expansion by osteotomy and internal distractors. Surg Neurol Int. 2018;9:217. https:\/\/doi.org\/10.4103\/sni.sni_465_17","DOI":"10.4103\/sni.sni_465_17"},{"key":"77778","doi-asserted-by":"crossref","unstructured":"de Jong T, van Veelen ML, Mathijssen IM. Spring-assisted posterior vault expansion in multisuture craniosynostosis. Childs Nerv Syst. 2013;29:815\u2013820. https:\/\/doi.org\/10.1007\/s00381-013-2033-8","DOI":"10.1007\/s00381-013-2033-8"},{"key":"77779","doi-asserted-by":"crossref","unstructured":"Tun\u00e7bilek G, Kayk\u00e7o\u011flu A, Bozkurt G, et al. Spring-mediated cranioplasty in patients with multiple-suture synostosis and cloverleaf skull deformity. J Craniofac Surg. 2012;23:374\u2013377. https:\/\/doi.org\/10.1097\/SCS.0b013e318240fc4d","DOI":"10.1097\/SCS.0b013e318240fc4d"},{"key":"77780","doi-asserted-by":"crossref","unstructured":"Ramdat Misier KRR, Breakey RWF, van de Lande LS, et al. Correlation between head shape and volumetric changes following spring-assisted posterior vault expansion. 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