Evolution of Craniosynostosis Care at a Single Institution Over an 11-Year Period.

Abstract

Background: Surgical correction of craniosynostosis is continuously evolving. There has been a shift from total vault procedures towards minimally invasive techniques, reflecting advances in the understanding of the condition and surgical technique. This study aims to document the evolution and outcomes of craniosynostosis care over an 11-year period at one academic institution.

Methods: Institutional review board approval was received. Patient demographics, operative details, and postoperative courses were collected for patients receiving surgical cranial vault correction for craniosynostosis at the authors' institution. Retrospective analysis was conducted with primary outcomes including intensive care unit (ICU) length of stay, estimated blood loss, and blood replacement volumes. χ2 tests and independent t tests determined significance (0.05).

Results: One hundred sixty-eight patients met the inclusion criteria. Total vault remodeling procedures, the most common procedure from 2012 to 2017, significantly decreased in 2018 to 2023. An increase in spring-assisted cranioplasties occurred in 2018 to 2023. Frontal orbital advancement remained a popular choice throughout the examined period. Spring cranioplasties and respective protocols correlated with shorter procedure times (P=0.003), reduced ICU length of stay (P=0.004), and lower morphine equivalents given per admission (P=0.002) compared with traditional techniques.

Conclusions: Craniosynostosis care has evolved considerably over the last decade. In the present study, the use of spring-assisted cranioplasty yielded benefits in reducing ICU stay and lowering morphine equivalents given. This study provides insights into how surgical care for craniosynostosis is adapting to new evidence-based studies and technologies, emphasizing the importance of continuous review and adaptation of treatment protocols.