{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T02:01:30Z","timestamp":1788141690002,"version":"build-2803163510"},"reference-count":39,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"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>Surgical treatment of craniosynostosis includes a wide range of techniques. Although a variety of more extensive cranioplasties have been employed to enhance outcomes, efforts to identify less invasive surgical approaches with better results continue. Since the introduction of springs as a tool for craniosynostosis surgery in 1997 at Sahlgrenska University Hospital in Gothenburg, Sweden, several studies have established their utility as an efficient surgical method. Because springs are currently used in the majority of our surgeries addressing craniosynostosis in children, this review summarizes our extensive experience with this method in more than 750 surgeries.<\/jats:p>","DOI":"10.2340\/jphs.v60.43315","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T04:28:19Z","timestamp":1745296099000},"page":"91-95","source":"Crossref","is-referenced-by-count":6,"title":["Dynamic osteodistraction with springs \u2013 the Gothenburg experience of spring-assisted cranioplasty"],"prefix":"10.2340","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2282-0256","authenticated-orcid":false,"given":"Peter","family":"Tarnow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Maltese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5569-0588","authenticated-orcid":false,"given":"Madiha","family":"Bhatti-S\u00f8fteland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-9362","authenticated-orcid":false,"given":"Karin","family":"S\u00e4lj\u00f6","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Holmstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Olsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3628-7686","authenticated-orcid":false,"given":"Tobias","family":"Hall\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9808-5935","authenticated-orcid":false,"given":"Lars","family":"K\u00f6lby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"107558","doi-asserted-by":"crossref","unstructured":"Galiay L, Hennocq Q, Cross C, et al. Management of sagittal craniosynostosis: morphological comparison of eight surgical techniques. Br J Oral Maxillofac Surg. 2022;60(4):499\u2013506. https:\/\/doi.org\/10.1016\/j.bjoms.2021.09.017","DOI":"10.1016\/j.bjoms.2021.09.017"},{"key":"107559","doi-asserted-by":"crossref","unstructured":"Maltese G, Tarnow P, Wikberg E, et al. Intracranial volume before and after surgical treatment for isolated metopic synostosis. J Craniofac Surg. 2014;25(1):262\u2013266. https:\/\/doi.org\/10.1097\/SCS.0000000000000423","DOI":"10.1097\/SCS.0000000000000423"},{"key":"107560","unstructured":"Uejima O. \u2018Expansive linear crainotomy\u2019 as a new operation method for the infants with small head. J Nara Med Assoc. 1967;18:287\u2013306."},{"key":"107561","doi-asserted-by":"crossref","unstructured":"Lauritzen C, Sugawara Y, Kocabalkan O, Olsson R. Spring mediated dynamic craniofacial reshaping. Case report. Scand J Plast Reconstr Surg Hand Surg. 1998;32(3):331\u2013338. https:\/\/doi.org\/10.1080\/02844319850158697","DOI":"10.1080\/02844319850158697"},{"key":"107562","doi-asserted-by":"crossref","unstructured":"Lauritzen CGK. The applications of springs in craniofacial surgery. J Craniofac Surg. 2020;31(7):2069\u20132070. https:\/\/doi.org\/10.1097\/SCS.0000000000006684","DOI":"10.1097\/SCS.0000000000006684"},{"key":"107563","doi-asserted-by":"crossref","unstructured":"Gewalli F, da Silva Guimaraes-Ferreira JP, Maltese G, \u00d6rtengren U, Lauritzen C. Expander elements in craniofacial surgery: an experimental study in rabbits. Scand J Plast Reconstr Surg Hand Surg. 2001;35(2):149\u2013156. https:\/\/doi.org\/10.1080\/028443101300165282","DOI":"10.1080\/028443101300165282"},{"key":"107564","doi-asserted-by":"crossref","unstructured":"Pignatti M, Hansson HA, Gewalli F. Calvarial bone healing under spring distension at continuous forces. Ann Plast Surg. 2006;57(5):561\u2013568. https:\/\/doi.org\/10.1097\/01.sap.0000229019.29857.14","DOI":"10.1097\/01.sap.0000229019.29857.14"},{"key":"107565","doi-asserted-by":"crossref","unstructured":"David LR, Gewalli F, Guimaraes-Ferreira J, Sanger C, Glazier S, Argenta LC. Dynamic spring-mediated cranioplasty in a rabbit model. J Craniofac Surg. 2002;13(6):794\u2013801.","DOI":"10.1097\/00001665-200211000-00015"},{"key":"107566","doi-asserted-by":"crossref","unstructured":"Davis C, Windh P, Lauritzen CG. Do expansile cranial springs erode through the cranium? J Craniofac Surg. 2009;20(1):168\u2013170. https:\/\/doi.org\/10.1097\/SCS.0b013e318191cf1d","DOI":"10.1097\/SCS.0b013e318191cf1d"},{"key":"107567","doi-asserted-by":"crossref","unstructured":"Michaelsson I, Skoglund T, Hall\u00e9n T, et al. Circulating brain-injury markers after surgery for craniosynostosis. World Neurosurg. 2023;173:e593\u2013e599. https:\/\/doi.org\/10.1016\/j.wneu.2023.02.102","DOI":"10.1016\/j.wneu.2023.02.102"},{"key":"107568","doi-asserted-by":"crossref","unstructured":"Davis C, Windh P, Lauritzen CG. Adaptation of the cranium to spring cranioplasty forces. Childs Nerv Syst. 2010;26(3):367\u2013371. https:\/\/doi.org\/10.1007\/s00381-009-1026-0","DOI":"10.1007\/s00381-009-1026-0"},{"key":"107569","doi-asserted-by":"crossref","unstructured":"Davis C, Lauritzen CGK. The biomechanical characteristics of cranial sutures are altered by spring cranioplasty forces. Plast Reconstr Surg. 2010;125(4):1111\u20131118.","DOI":"10.1097\/PRS.0b013e3181d0abcf"},{"key":"107570","doi-asserted-by":"crossref","unstructured":"Tarnow P, K\u00f6lby L, Maltese G, et al. Incidence of Non-Syndromic and Syndromic Craniosynostosis in Sweden. J Craniofac Surg. 2022;33(5):1517\u20131520. https:\/\/doi.org\/10.1097\/SCS.00\u200b00000000008457","DOI":"10.1097\/SCS.0000000000008457"},{"key":"107571","doi-asserted-by":"crossref","unstructured":"Guimaraes-Ferreira J, Gewalli F, David L, Olsson R, Friede H, Lauritzen CG. Spring-mediated cranioplasty compared with the modified pi-plasty for sagittal synostosis. Scand J Plast Reconstr Surg Hand Surg. 2003;37(4):208\u2013215. https:\/\/doi.org\/10.1080\/02844310310001823","DOI":"10.1080\/02844310310001823"},{"key":"107572","doi-asserted-by":"crossref","unstructured":"Fischer S, Maltese G, Tarnow P, Wikberg E, Bernhardt P, K\u00f6lby L. Comparison of intracranial volume and cephalic index after correction of sagittal synostosis with spring-assisted surgery or pi-plasty. J Craniofac Surg. 2016;27(2):410\u2013413. https:\/\/doi.org\/10.1097\/SCS.0000000000002519","DOI":"10.1097\/SCS.0000000000002519"},{"key":"107573","doi-asserted-by":"crossref","unstructured":"Fischer S, Maltese G, Tarnow P, Wikberg E, S\u00f8fteland MB, K\u00f6lby L. Comparisons of intracranial volume and cephalic index after correction of sagittal craniosynostosis with either two or three springs. J Craniofac Surg. 2021;32(8):2636\u20132640. https:\/\/doi.org\/10.1097\/SCS.0000000000007870","DOI":"10.1097\/SCS.0000000000007870"},{"key":"107574","doi-asserted-by":"crossref","unstructured":"Fischer S, Unander-Scharin J, Bhatti-S\u00f8fteland M, et al. Springs produce favorable morphological outcomes relative to H-craniectomy according to a two-center comparison of matched cases. Plast Reconstr Surg. 2024;154:317e\u2013325e. https:\/\/doi.org\/10.1097\/PRS.0000000000010761","DOI":"10.1097\/PRS.0000000000010761"},{"key":"107575","doi-asserted-by":"crossref","unstructured":"Maltese G, Tarnow P, Lauritzen CG. Spring-assisted correction of hypotelorism in metopic synostosis. Plast Reconstr Surg. 2007;119(3):977\u2013984. https:\/\/doi.org\/10.1097\/01.prs.000025\u200b2276.46113.ee","DOI":"10.1097\/01.prs.0000252276.46113.ee"},{"key":"107576","doi-asserted-by":"crossref","unstructured":"Maltese G, Tarnow P, Tovetj\u00e4rn R, K\u00f6lby L. Correction of hypotelorism in isolated metopic synostosis. J Plast Surg Hand Surg. 2014;48(1):63\u201366. https:\/\/doi.org\/10.3109\/2000656X.2013.812967","DOI":"10.3109\/2000656X.2013.812967"},{"key":"107577","doi-asserted-by":"crossref","unstructured":"Bhatti-S\u00f8fteland M, Mellgren J, S\u00e4lj\u00f6 K, et al. Correction of unicoronal synostosis with springs: two patients with improved facial symmetry. J Craniofac Surg. 2023;35(1):10\u201312. https:\/\/doi.org\/10.1097\/SCS.0000000000009842","DOI":"10.1097\/SCS.0000000000009842"},{"key":"107578","doi-asserted-by":"crossref","unstructured":"Mellgren J, Liang C, Buzi C, Profico A, Khonsari RH, S\u00e4lj\u00f6 K, Moazen M, K\u00f6lby L. Surgical Correction of Unicoronal Synostosis: Fronto-orbital Distraction versus Calvarial Switch. Plast Reconstr Surg. 2024 Dec 17. doi: 10.1097\/PRS.0000000000011923. Epub ahead of print. PMID: 39688622.","DOI":"10.1097\/PRS.0000000000011923"},{"key":"107579","doi-asserted-by":"crossref","unstructured":"Lauritzen C, Friede H, Elander A, Olsson R, Jensen P. Dynamic cranioplasty for brachycephaly. Plast Reconstr Surg. 1996;98(1):7\u201314; discussion 5\u20136.","DOI":"10.1097\/00006534-199607000-00002"},{"key":"107580","doi-asserted-by":"crossref","unstructured":"Tovetj\u00e4rn R, Maltese G, K\u00f6lby L, Kreiborg S, Tarnow P. Spring-assisted cranioplasty for bicoronal synostosis. J Craniofac Surg. 2012;23(4):977\u2013981. https:\/\/doi.org\/10.1097\/SCS.0b013e31824e2bec","DOI":"10.1097\/SCS.0b013e31824e2bec"},{"key":"107581","doi-asserted-by":"crossref","unstructured":"Mellgren J, Maltese G, Tarnow P, Bhatti-Softeland M, Kolby L, Saljo K. Spring-assisted surgery of unilambdoid craniosynostosis. J Craniofac Surg. 2024;35(3):715\u2013720.","DOI":"10.1097\/SCS.0000000000010035"},{"key":"107582","doi-asserted-by":"crossref","unstructured":"Bevilacqua R, Tarnow P, K\u00f6lby L, Maltese G. Spring-assisted surgery in the treatment of complex craniosynostosis. J Craniofac Surg. 2018;29(4):920\u2013924. https:\/\/doi.org\/10.1097\/SCS.0000000000004377","DOI":"10.1097\/SCS.0000000000004377"},{"key":"107583","doi-asserted-by":"crossref","unstructured":"S\u00e4lj\u00f6 K, Bhatti-S\u00f8fteland M, Tarnow P, et al. Spring-assisted posterior vault expansion in children over 2 years of age with craniosynostosis. J Plast Surg Hand Surg. 2024;59:117\u2013122.","DOI":"10.2340\/jphs.v59.41906"},{"key":"107584","doi-asserted-by":"crossref","unstructured":"Paganini A, Bhatti-S\u00f8fteland M, Fischer S, et al. In search of a single standardised system for reporting complications in craniofacial surgery: a comparison of three different classifications. J Plast Surg Hand Surg. 2019;53(6):321\u2013327. https:\/\/doi.org\/10.1080\/2000656X.2019.1626736","DOI":"10.1080\/2000656X.2019.1626736"},{"key":"107585","doi-asserted-by":"crossref","unstructured":"Lauritzen CGK, Davis C, Ivarsson A, Sanger C, Hewitt TD. The evolving role of springs in craniofacial surgery: the first 100 clinical cases. Plast Reconstr Surg. 2008;121(2):545\u2013554. https:\/\/doi.org\/10.1097\/01.prs.0000297638.76602.de","DOI":"10.1097\/01.prs.0000297638.76602.de"},{"key":"107586","doi-asserted-by":"crossref","unstructured":"Bakri S, Mazeed AS, Saied S, et al. Introduction of spring-\u00adassisted cranioplasty for sagittal craniosynostosis in a craniofacial service: a report of early experience. J Craniofac Surg. 2023;34(3):899\u2013903.","DOI":"10.1097\/SCS.0000000000009065"},{"key":"107587","doi-asserted-by":"crossref","unstructured":"David LR, Proffer P, Hurst WJ, Glazier S, Argenta LC. Spring-mediated cranial reshaping for craniosynostosis. J Craniofac Surg. 2004;15(5):810\u2013816; discussion 7\u20138. https:\/\/doi.org\/\u200b10.1097\/00001665-200409000-00021","DOI":"10.1097\/00001665-200409000-00021"},{"key":"107588","doi-asserted-by":"crossref","unstructured":"David LR, Plikaitis CM, Couture D, Glazier SS, Argenta LC. Outcome analysis of our first 75 spring-assisted surgeries for scaphocephaly. J Craniofac Surg. 2010;21(1):3\u20139. https:\/\/doi.org\/10.1097\/SCS.0b013e3181c3469d","DOI":"10.1097\/SCS.0b013e3181c3469d"},{"key":"107589","doi-asserted-by":"crossref","unstructured":"Satanin L, Teterin I, Evteev A, et al. Introduction of spring-assisted cranioplasty for scaphocephaly in Russia: first cases evaluated using detailed craniometry and principal component analysis. J Plast Surg Hand Surg. 2019;53(3):173\u2013179. https:\/\/doi.org\/10.1080\/2000656X.2019.1571501","DOI":"10.1080\/2000656X.2019.1571501"},{"key":"107590","doi-asserted-by":"crossref","unstructured":"Runyan CM, Park JG, Blaha L, et al. Outcomes of endoscopic versus open spring assisted surgery for sagittal craniosynostosis. J Craniofac Surg. 2020;31(7):2088\u20132091. https:\/\/doi.org\/\u200b10.1097\/SCS.0000000000006709","DOI":"10.1097\/SCS.0000000000006709"},{"key":"107591","doi-asserted-by":"crossref","unstructured":"K\u00f6lby D, Fischer S, Arab K, et al. Craniotomy of the fused sagittal suture over the superior sagittal sinus is a safe procedure. J Craniofac Surg. 2017;28(3):650\u2013653. https:\/\/doi.org\/10.1097\/SCS.0000000000003440","DOI":"10.1097\/SCS.0000000000003440"},{"key":"107592","doi-asserted-by":"crossref","unstructured":"Guimaraes-Ferreira J, Gewalli F, David L, Maltese G, Heino H, Lauritzen C. Calvarial bone distraction with a contractile bioresorbable polymer. Plast Reconstr Surg. 2002;109(4):1325\u20131331; discussion 32. https:\/\/doi.org\/10.1097\/00006534-200204010-00017","DOI":"10.1097\/00006534-200204010-00017"},{"key":"107593","unstructured":"Bauer S. Development of resorbable \u2018springs\u2019 for surgery. Material properties and biocompability. [Master Degree project report in Biomedical Engineering]. Gothenburg, Sweden: Chalmers University of Technology; 2024."},{"key":"107594","doi-asserted-by":"crossref","unstructured":"Valetopoulou A, Constantinides M, Eccles S, et al. Endoscopic strip craniectomy with molding helmet therapy versus spring-assisted cranioplasty for nonsyndromic single-suture sagittal craniosynostosis: a systematic review. J Neurosurg Pediatr. 2022;30(4):455\u2013462. https:\/\/doi.org\/10.3171\/2022.7.PEDS2232","DOI":"10.3171\/2022.7.PEDS2232"},{"key":"107595","doi-asserted-by":"crossref","unstructured":"Selvaggi G, Maltese G, K\u00f6lby L, Elander A, Tarnow P, Kljajic M. Ethical considerations in surgery for single-suture craniosynostosis. J Craniofac Surg. 2023;34(7):1922\u20131926. https:\/\/doi.org\/10.1097\/SCS.0000000000009590","DOI":"10.1097\/SCS.0000000000009590"},{"key":"107596","doi-asserted-by":"crossref","unstructured":"Mathijssen IM. Guideline for care of patients with the diagnoses of craniosynostosis: working group on craniosynostosis. J Craniofac Surg. 2015;26(6):1735\u20131807. https:\/\/doi.org\/10.1097\/SCS.0000000000002016","DOI":"10.1097\/SCS.0000000000002016"}],"container-title":["Journal of Plastic Surgery and Hand Surgery"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/43315\/49921","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/43315\/49921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T04:28:29Z","timestamp":1745296109000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/view\/43315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,22]]},"references-count":39,"URL":"https:\/\/doi.org\/10.2340\/jphs.v60.43315","relation":{},"ISSN":["2000-6764","2000-656X"],"issn-type":[{"value":"2000-6764","type":"electronic"},{"value":"2000-656X","type":"print"}],"subject":[],"published":{"date-parts":[[2025,4,22]]}}}