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Okishev D.N.

Burdenko Neurosurgical Center

Konovalov An.N.

Burdenko Neurosurgical Center

Artemyev A.A.

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

Okisheva E.A.

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

Pilipenko Yu.V.

Burdenko Neurosurgical Center

Eliava Sh.Sh.

Burdenko Neurosurgical Center

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

Views: 922

Downloaded: 60

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Table of contents

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 (Burdenko's Journal of Neurosurgery)
 
 
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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

Konovalov An.N.

Burdenko Neurosurgical Center

Artemyev A.A.

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

Okisheva E.A.

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

Pilipenko Yu.V.

Burdenko Neurosurgical Center

Eliava Sh.Sh.

Burdenko Neurosurgical Center

Received:

30.10.2023

Accepted:

12.01.2024

List of references:

  1. 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
  2. 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
  3. 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.
  4. 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
  5. Hamby WB. A tantalum cranial clip. Journal of Neurosurgery. 1944;1:331. 
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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

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