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

Technical note

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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.


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.


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.


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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    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.



Berryhill WERimell FLNess JMarentette LHaines SJ: Fate of rigid fixation in pediatric cranial surgery. Otolaryngol Head Nech Surg 121:2692731999


Dickerman RDMcConathy WJPearl NAStevens QECohen ASchneider SJ: Pediatric cranial fixation: a survey of pediatric neurosurgeons. J Craniofac Surg 13:7697712002


Eckelt UNitsche MMüeller APilling EPinzer TRoesner D: Ultrasound aided pin fixation of biodegradable osteosynthetic materials in cranioplasty for infants with craniosynostosis. J Craniomaxillofac Surg 35:2182212007


Eppley BLMorales LWood RPensler JGoldstein JHavlik RJ: Resorbable PLLA-PGA plate and screw fixation in pediatric craniofacial surgery: clinical experience in 1883 patients. Plast Reconstr Surg 114:8508562004


Eppley BLPietrzak WS: A resorbable rivet system for pediatric craniofacial surgery: biomechanical testing and clinical experience. J Craniofac Surg 17:11142006


Kumar CRSood SHam S: Complications of bioresorbable fixation systems in pediatric neurosurgery. Childs Nerv Syst 21:2052102005


Kurpad SNGoldstein JACohen AR: Bioresorbable fixation for congenital pediatric craniofacial surgery: a 2-year followup. Pediatr Neurosurg 33:3063102000


Lerch KD: Reliability of cranial flap fixation techniques: comparative experimental evaluation of suturing, titanium miniplates, and a new rivet-like titanium clamp (CranioFix): technical note. Neurosurgery 44:9029051999


Pilling EMai RTheissig FStadlinger BLoukota REckelt U: An experimental in vivo analysis of the resorption to ultrasound activated pins (Sonic Weld) and standard biodegradable screws (ResorbX) in sheep. Br J Oral Maxillofac Surg 45:4474502007


Pilling EMeissner HJung RKoch RLoukota RMai R: An experimental study of the biomechanical stability of ultrasound-activated pinned (SonicWeld Rx+Resorb-X) and screwed fixed (Resorb-X) resorbable materials for osteosynthesis in the treatment of simulated craniosynostosis in sheep. Br J Oral Maxillofac Surg 45:4514562007


Sanus GZTanriverdi TKacira TJackson IT: Effects of rigid fixation on the growing neurocranium of immature rabbits. J Craniofac Surg 18:3153242007


Winston KRWang MC: Cranial bone fixation in infants and children. Pediatr Neurosurg 31:2252301999


Winston KRWang MC: Cranial bone fixation: review of the literature and description of a new procedure. J Neurosurg 99:4844882003




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