{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:39:57Z","timestamp":1792651197470,"version":"4.5.0"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,8]]},"abstract":"\n OBJECTIVE<\/jats:title>\n One of the principles of the surgical treatment of craniosynostosis includes the release of fused bone plates to prevent recurrence. Such bone defects require a reossification process after surgery to prevent a cosmetic problem or brain vulnerability to damage. The objective of this study is to describe and analyze the radiological and clinical evolution of bone defects after craniosynostosis.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n From January 2005 to May 2016, 248 infants underwent surgical correction of craniosynostosis at HUiP La Fe Valencia; the authors analyzed data from 216 of these cases that met the inclusion criteria for this study. Various surgical techniques were used according to the age of the patient and severity of the case, including endoscopic-assisted suturectomy, open suturectomy, fronto-orbital advancement, and cranial vault remodeling. Clinical follow-up and radiological quantitative measurements in 2 periods\u201412\u201324 months and 2 years after surgery\u2014were analyzed; 94 patients had a postoperative CT scan and were included in the radiological analysis.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n At the end of the follow-up period, 92 of 216 patients (42.59%) showed complete closure of the bone defect, 112 patients (51.85%) had minor bone defects, and 12 patients (5.56%) had significant bone defects that required surgical intervention. In the multivariate analysis, age at first surgery was not significantly associated with incomplete reossification (p = 0.15), nor was surgical site infection (p = 0.75). Multivariate analysis identified area of cranial defect greater than 5 cm\n 2<\/jats:sup>\n in the first CT scan as predictive of incomplete reossification (p = 0.04). The mean area of cranial defect in the first CT scan (12\u201324 months after surgery) was 3.69 cm\n 2<\/jats:sup>\n in patients treated with open surgery and 7.13 cm\n 2<\/jats:sup>\n in those treated with endoscopic-assisted procedures; in the multivariate analysis, type of procedure was not related to incomplete reossification (p = 0.46). The positive predictive value of palpation as evaluation of bone cranial defects was 50% for significant defects and 71% for minor defects.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n \n The incidence of cranial defects due to incomplete reossification requiring cranioplasty was 5.56% in our series. Defects greater than 5 cm\n 2<\/jats:sup>\n in the first postoperative CT scan showed a positive association with incomplete reossification. Patients treated with endoscope-assisted procedures had larger defects in the initial follow-up, but the final incidence of cranial defects was not significantly different in the endoscope-assisted surgery group from that in the open surgery group.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2018.2.peds17717","type":"journal-article","created":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T09:56:01Z","timestamp":1527242161000},"page":"120-127","source":"Crossref","is-referenced-by-count":25,"title":["Incomplete reossification after craniosynostosis surgery\u2014incidence and analysis of risk factors: a clinical-radiological assessment study"],"prefix":"10.3171","volume":"22","author":[{"given":"Jos\u00e9 Luis","family":"Thenier-Villa","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, HUiP La Fe, Valencia; and"},{"name":"Department of Neurosurgery, University Hospital Complex of Vigo, Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Sanrom\u00e1n-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, HUiP La Fe, Valencia; and"},{"name":"Department of Neurosurgery, University Hospital Complex of Vigo, Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Miranda-Lloret","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, HUiP La Fe, Valencia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Estela","family":"Plaza Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, HUiP La Fe, Valencia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1097\/SCS.0000000000002556","article-title":"Telemetric intracranial pressure monitoring in syndromic craniosynostosis","volume":"27","author":"Beez T","year":"2016","unstructured":"Beez T, O\u2019Kane R, Piper I, Koppel D, Sangra M: Telemetric intracranial pressure monitoring in syndromic craniosynostosis. 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