Comparison of polymethyl methacrylate skull implant fixation by three types of titanium fasteners

Okishev D.N.; Konovalov An.N.; Artemyev A.A.; Okisheva E.A.; Pilipenko Yu.V.; Eliava Sh.Sh.

doi:https://doi.org/10.17116/neiro20248802123

Okishev D.N.

Burdenko Neurosurgical Center

ORCID: 0000-0003-0815-5624

Konovalov An.N.

Burdenko Neurosurgical Center

ORCID: 0000-0002-0932-4752

Artemyev A.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-3537-7997

Okisheva E.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-2977-7203

Pilipenko Yu.V.

Burdenko Neurosurgical Center

ORCID: 0000-0003-4001-3212

Eliava Sh.Sh.

Burdenko Neurosurgical Center

ORCID: 0000-0001-6103-9329

Comparison of polymethyl methacrylate skull implant fixation by three types of titanium fasteners

Authors:

Okishev D.N., Konovalov An.N., Artemyev A.A., Okisheva E.A., Pilipenko Yu.V., Eliava Sh.Sh.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2024;88(2): 23‑30

DOI: 10.17116/neiro20248802123

Read: 2117 times

To cite this article:

Okishev DN, Konovalov AnN, Artemyev AA, Okisheva EA, Pilipenko YuV, Eliava ShSh. Comparison of polymethyl methacrylate skull implant fixation by three types of titanium fasteners. Burdenko's Journal of Neurosurgery. 2024;88(2):23‑30. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248802123

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To evaluate mechanical strength of three methods of polymethyl methacrylate skull implant fixation in two experimental models.

MATERIAL AND METHODS

The first experiment was performed on a plastic model that was as close as possible to bone in structural characteristics. The second experiment was performed on a biological specimen (a ram’s head). We assessed the quality of implant fixation to bone window edges by craniofixes, ties and microscrews and lateral intercortical screws.

RESULTS

Craniofixes are feasible for small flat flaps, but not advisable for wide highly curved implants. They are also the most expensive method of fixation. Implant fixation by ties and microscrews is a universal method comparable in price to craniofix. Lateral intercortical fixation is effective both for small flat implants and wide implants with large curvature. However, this method is not always applicable.

CONCLUSION

Combined fixation by lateral intercortical screws and ties allows for the most effective fixation while reducing the overall price of consumables.

Keywords:

cranioplasty

methods of implant fixation

3D modeling in neurosurgery

Authors:

Okishev D.N.

Burdenko Neurosurgical Center

ORCID: 0000-0003-0815-5624

Konovalov An.N.

Burdenko Neurosurgical Center

ORCID: 0000-0002-0932-4752

Artemyev A.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-3537-7997

Okisheva E.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-2977-7203

Pilipenko Yu.V.

Burdenko Neurosurgical Center

ORCID: 0000-0003-4001-3212

Eliava Sh.Sh.

Burdenko Neurosurgical Center

ORCID: 0000-0001-6103-9329

Received:

30.10.2023

Accepted:

12.01.2024

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References:

Piazza M, Grady MS. Cranioplasty. Neurosurgery Clinics of North America. 2017;28(2):257-265. https://doi.org/10.1016/j.nec.2016.11.008
Okishev DN, Cherebylo SA, Konovalov AnN, Chelushkin DM, Shekhtman OD, Konovalov NA, Okisheva EA, Kravchuk AD, Eliava ShSh. Features of modeling, manufacturing and installation of polymer implants for closing a skull defect after decompressive trepanation. Burdenko’s Journal of Neurosurgery. 2022;86(1):17-27. (In Russ.). https://doi.org/10.17116/neiro20228601117
Keen WW. Surgery of the brain, spinal cord, and nerves. In: Dercum FX, ed. A Text-Book on Nervous Diseases by American Authors. Philadelphia: Lea Brothers; 1895.
Hudson WH. A new decompression operation for the brain. Annals of Surgery. 1912;55(5):744-749. https://doi.org/10.1097/00000658-191205000-00006
Hamby WB. A tantalum cranial clip. Journal of Neurosurgery. 1944;1:331.
Persing JA, Posnick J, Magge S, Spinelli HM, Wolfe SA, Munro I, Mulliken JB. Cranial plate and screw fixation in infancy: an assessment of risk. Journal of Craniofacial Surgery. 1996;7(4):267-270. https://doi.org/10.1097/00001665-199607000-00003
Smith SC, Pelofsky S. Adaptation of rigid fixation to cranial flap replacement. Neurosurgery. 1991;29(3):417-418. https://doi.org/10.1097/00006123-199109000-00013
Estin D, Troffkin N, Heilman CB. Bone flap fixation with titanium clamps: a new technique. Surgical Neurology. 2000;53(4):391-394; discussion 394-395. https://doi.org/10.1016/s0090-3019(00)00186-5
Spetzler RF. Bone flap fixation: a new technique. Technical note. Journal of Neurosurgery. 1997;87(3):475-476. https://doi.org/10.3171/jns.1997.87.3.0475
Winston KR, Wang MC. Cranial bone fixation: review of the literature and description of a new procedure. Journal of Neurosurgery. 2003;99(3):484-488. https://doi.org/10.3171/jns.2003.99.3.0484
Yoo M, Lee S, Jin SC, Kim JS. Self-releasing of a titanium clamp (CranioFix) in cranioplasty. British Journal of Neurosurgery. 2019;33(3):320-321. https://doi.org/10.1080/02688697.2018.1523366
Park S, Lee J, Kim J, Hur J, Yun IG, Lee H. Releasing of a Titanium Clamp (Craniofix) Without Mechanical Defect After Craniotomy for Acute Subdural Hemorrhage. Korean Journal of Neurotrauma. 2022;18(2):357-360. https://doi.org/10.13004/kjnt.2022.18.e50