{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T20:32:42Z","timestamp":1782246762823,"version":"3.54.5"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:p>Cranioplasty is routinely performed following decompressive craniectomy in both adult and pediatric populations. In adults, this procedure is associated with higher rates of complications than is elective cranial surgery. This study is a review of the literature describing risk factors for complications after cranioplasty surgery in pediatric patients. A systematic search of PubMed, Cochrane, and SCOPUS databases was undertaken. Articles were selected based on their titles and abstracts. Only studies that focused on a pediatric population were included; case reports were excluded. Studies in which the authors assessed bone flap storage method, timing of cranioplasty, material used (synthetic vs autogenous), skull defect size, and\/or complication rates (bone resorption and surgical site infection) were selected for further analysis. Eleven studies that included a total of 441 cranioplasties performed in the pediatric population are included in this review.<\/jats:p>\n<jats:p>The findings are as follows: 1) Based on analysis of pooled data, using cryopreserved bone flaps during cranioplasty may lead to a higher rate of bone resorption and lower rate of infection than using bone flaps stored at room temperature. 2) In 3 of 4 articles describing the effect of time between craniectomy and cranioplasty on complication rate, the authors found no significant effect, while in 1 the authors found that the incidence of bone resorption was significantly lower in children who had undergone early cranioplasty. Pooling of data was not possible for this analysis. 3) There are insufficient data to assess the effect of cranioplasty material on complication rate when considering only cranioplasties performed to repair decompressive craniectomy defects. However, when considering cranioplasties performed for any indication, those in which freshly harvested autograft is used may have a lower rate of resorption than those in which stored autograft is used. 4) There is no appreciable effect of craniectomy defect size or patient age on complication rate.<\/jats:p>\n<jats:p>There is a paucity of articles describing outcomes and complications following cranioplasty in children and adolescents. However, based on the studies examined in this systematic review, there are reasons to suspect that method of flap preservation, timing of surgery, and material used may be significant. Larger prospective and retrospective studies are needed to shed more light on this important issue.<\/jats:p>","DOI":"10.3171\/2013.4.peds12605","type":"journal-article","created":{"date-parts":[[2013,6,21]],"date-time":"2013-06-21T14:30:09Z","timestamp":1371825009000},"page":"120-125","source":"Crossref","is-referenced-by-count":82,"title":["Outcomes of cranioplasty following decompressive craniectomy in the pediatric population"],"prefix":"10.3171","volume":"12","author":[{"given":"Brandon G.","family":"Rocque","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Wisconsin, Madison, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaushik","family":"Amancherla","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, University of Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean M.","family":"Lew","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandi","family":"Lam","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, University of Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds12605","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/0090-3019(86)90339-3","article-title":"Histopathologic and microdensitometric analysis of craniotomy bone flaps preserved between abdominal fat and muscle","volume":"26","author":"A\u00e7ikg\u00f6z","year":"1986"},{"key":"b2-peds12605","series-title":"Childs Brain","first-page":"82","article-title":"Cranioplasty in children","volume":"6","author":"Blair","year":"1980"},{"key":"b3-peds12605","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1159\/000121158","article-title":"Methyl methacrylate cranioplasty in children: long-term results","volume":"26","author":"Blum","year":"1997"},{"key":"b4-peds12605","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"526","DOI":"10.3171\/2013.1.PEDS12483","article-title":"Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury. Clinical article","volume":"11","author":"Bowers","year":"2013"},{"key":"b5-peds12605","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.3171\/2009.6.JNS09133","article-title":"Outcomes of cranial repair after craniectomy. Clinical article","volume":"112","author":"Chang","year":"2010"},{"key":"b6-peds12605","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00701-011-1253-5","article-title":"Complications of delayed cranial repair after decompressive craniectomy in children less than 1 year old","volume":"154","author":"Frassanito","year":"2012"},{"issue":"6","key":"b7-peds12605","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E9","DOI":"10.3171\/2009.3.FOCUS0962","article-title":"Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases","volume":"26","author":"Gooch","year":"2009"},{"issue":"2 Suppl Pediatrics","key":"b8-peds12605","series-title":"J Neurosurg","first-page":"163","article-title":"Failure of autologous bone-assisted cranioplasty following decompressive craniectomy in children and adolescents","volume":"100","author":"Grant","year":"2004"},{"key":"b9-peds12605","series-title":"Z Kinderchir","first-page":"375","article-title":"The prognosis of cranioplasty following large craniectomy in children","volume":"43","author":"Gruber","year":"1988"},{"key":"b10-peds12605","series-title":"J Trauma","first-page":"183","article-title":"Does difference in the storage method of bone flaps after decompressive craniectomy affect the incidence of surgical site infection after cranioplasty? Comparison between subcutaneous pocket and cryopreservation","volume":"68","author":"Inamasu","year":"2010"},{"key":"b11-peds12605","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"440","DOI":"10.3171\/JNS-07\/08\/0440","article-title":"Ethylene oxide gas sterilization: a simple technique for storing explanted skull bone. Technical note","volume":"107","author":"Jho","year":"2007"},{"key":"b12-peds12605","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1007\/s00381-004-1068-2","article-title":"Cranioplasty in children","volume":"21","author":"Josan","year":"2005"},{"key":"b13-peds12605","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1007\/s00701-006-0740-6","article-title":"Analyses of the factors influencing bone graft infection after delayed cranioplasty","volume":"148","author":"Matsuno","year":"2006"},{"key":"b14-peds12605","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"268","DOI":"10.3171\/2012.6.PEDS1268","article-title":"Optimal timing of autologous cranioplasty after decompressive craniectomy in children. 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