caa a22 4500 606216472 CHVBK 20210128105230.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s00701-014-2310-7 doi (NATIONALLICENCE)springer-10.1007/s00701-014-2310-7 What happens to the bone flap? Long-term outcome after reimplantation of cryoconserved bone flaps in a consecutive series of 92 patients [Elektronische Daten] [Lennart Stieglitz, Christian Fung, Michael Murek, Jens Fichtner, Andreas Raabe, Jürgen Beck] Background: Reimplantation of cryoconserved autologous bone flaps is a standard procedure after decompressive craniotomies. Aseptic necrosis and resorption are the most frequent complications of this procedure. At present there is no consensus regarding the definition of the relevant extent and indication for surgical revision. The objective of this retrospective analysis was to identify the incidence of bone flap resorption and the optimal duration of follow-up. Methods: Between February 2009 and March 2012, 100 cryoconserved autologous bone flaps were reimplanted at the Department of Neurosurgery, Inselspital Bern. Three patients were not available for follow-up, and five patients died before follow-up. All patients underwent follow-up at 6weeks and a second follow-up more than 12months postoperatively. A clinical and CT-based score was developed for judgment of relevance and decision making for surgical revision. Results: Mean follow-up period was 21.6months postoperatively (range: 12 to 47months); 48.9% (45/92) of patients showed no signs of bone flap resorption, 20.7% (19/92) showed minor resorption with no need for surgical revision, and 30.4% (28/92) showed major resorption (in 4% of these the bone flap was unstable or collapsed). Conclusions: Aseptic necrosis and resorption of reimplanted autologous bone flaps occurred more frequently in our series of patients than in most reports in the literature. Most cases were identified between 6 and 12months postoperatively. Clinical observation or CT scans of patients with autologous bone flaps are recommended for at least 12months. Patient-specific implants may be preferable to autologous bone flaps. Springer-Verlag Wien, 2014 Aseptic bone flap necrosis nationallicence Bone flap nationallicence Bone flap resorption nationallicence Hemicraniectomy nationallicence Stieglitz Lennart Department of Neurosurgery, Zurich University Hospital, 8091, Zurich, Switzerland aut Fung Christian Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut Murek Michael Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut Fichtner Jens Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut Raabe Andreas Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut Beck Jürgen Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut Acta Neurochirurgica Springer Vienna 157/2(2015-02-01), 275-280 0001-6268 157:2<275 2015 157 701 https://doi.org/10.1007/s00701-014-2310-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-014-2310-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Stieglitz Lennart Department of Neurosurgery, Zurich University Hospital, 8091, Zurich, Switzerland aut NATIONALLICENCE 700 1- Fung Christian Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut NATIONALLICENCE 700 1- Murek Michael Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut NATIONALLICENCE 700 1- Fichtner Jens Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut NATIONALLICENCE 700 1- Raabe Andreas Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut NATIONALLICENCE 700 1- Beck Jürgen Department of Neurosurgery, Bern University Hospital, Bern, Switzerland aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/2(2015-02-01), 275-280 0001-6268 157:2<275 2015 157 701 SWISSBIB 603757049