Autogenous Bone Graft versus Artificial Substitutes in Cranioplasty

Abstract

Cranioplasty is a routine procedure in neurosurgery. However, it has a high postoperative complication rate up to 40%. The lack of good prospective studies and the small number of patients who receive artificial substitutes make it difficult to choose between different materials and the decision is mostly based on subjective or economic reasons. The main goal of this study was to compare the most common complications related to the implant within the first year after implantation. Methods: This prospective randomized clinical study has been carried out on 32 patients with cranial defects of different etiologies, sites and sizes which have been operated in Assiut University Hospital from January 2016 to January 2017. The patients were randomized into two groups: Autologous and Artificial group. Each group has 16 patients. Results: The overall complication rate in autologous group was found to be (25%) and in artificial group (37.5%). Infection in autologous group was found in (6.25%), in artificial group was found in (12.5%). Bone resorption was found in (12.5%). For epidural hematoma and wound dehiscence each has a rate of (6.25%). Poor cosmetic result in (18.75%) of artificial group. Conclusion: Cranioplasty is not without complications. However, good decision making, good timing and proper surgical techniques can provide excellent results. Primary titanium mesh cranioplasty should be considered especially in young adult patients with traumatic aetiology of bone defect.