Ultrasound-aided fixation of a biodegradable cranial fixation system: uses in pediatric neurosurgery

Technical note

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Object

Bioresorbable implant systems have been used in neurosurgery for the rigid fixation of cranial and facial bones. A relatively recent advancement has been the fixation of these implants using an ultrasonic device. The experience with such a device in neurosurgical practice has been limited. The authors report on their experience with ultrasound-aided fixation of bioresorbable implants in pediatric neurosurgical practice.

Methods

The study consisted of 2 parts. The retrospective portion consisted of a chart review of pertinent clinical information, complications, and outcomes after the use of a commercially available ultrasound-aided bioresorbable implant system (SonicWeld Rx, KLS Martin L.P.). Follow-up was obtained in all patients via clinical examination or telephone interview. The prospective portion of the study consisted of video analysis of the implantation technique in a routine craniotomy. Implantation times were measured, and delays during treatment were noted.

Results

Over a period of 2 years, 28 consecutive patients underwent placement of these implants for bone fixation during craniotomies or craniofacial reconstructions. The only complication was seen in a child with Crouzon syndrome, who had a wound infection caused by Serratia sepsis from a central venous line infection. There were no repeated operations for implant-related swelling, and no cases of premature plate resorption, bone instability, or settling. In vivo, the average time required to implant a resorbable pin with this system was 22 seconds.

Conclusions

The use of a bioresorbable implant system with ultrasound-aided pin fixation in pediatric neurosurgery cases achieved adequate stability with few complications. This system was easy to use and provided rapid fixation of implants.

Article Information

Address correspondence to: Philipp R. Aldana, M.D., Lucy Gooding Pediatric Neurosurgery Center, 836 Prudential Drive, Pavilion Building, Suite 1005, Jacksonville, Florida 32207. email: philipp.aldana@jax.ufl.edu.

© AANS, except where prohibited by US copyright law.

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Figures

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    Photographs of ultrasound-aided implantation equipment. A: The ultrasonic handpiece (Sonotrode) is connected by a cable to the base unit (SonicWeld Rx). The handheld drill with disposable drillbit is to the right of the handpiece. B: The resorbable pin is securely mounted to the tip of the handpiece. C: The pin is shown being welded into place with the handpiece.

References

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