Three-Dimensional Calvarial Growth in Spring-Assisted Cranioplasty for Correction of Sagittal Synostosis
Open accessAbstract
Spring-assisted cranioplasty (SAC) is a minimally invasive technique for treating sagittal synostosis in young infants. Yet, follow-up data on cranial growth in patients who have undergone SAC are lacking. This project aimed to understand how the cranial shape develops during the postoperative period, from spring insertion to removal. 3D head scans of 30 consecutive infants undergoing SAC for sagittal synostosis were acquired using a handheld scanner pre-operatively, immediately postoperatively, at follow-up and at spring removal; 3D scans of 41 age-matched control subjects were also acquired. Measurements of head length, width, height, circumference, and volume were taken for all subjects; cephalic index (CI) was calculated. Statistical shape modeling was used to compute 3D average head models of sagittal patients at the different time points. SAC was performed at a mean age of 5.2 months (range 3.3–8.0) and springs were removed 4.3 months later. CI increased significantly (P < 0.001) from pre-op (69.5% ± 2.8%) to spring removal (74.4% ± 3.9%), mainly due to the widening of head width, which became as wide as for age-matched controls; however, the CI of controls was not reached (82.3% ± 6.8%). The springs did not constrain volume changes and allowed for natural growth. Population mean shapes showed that the bony prominences seen at the sites of spring engagement settle over time, and that springs affect the overall 3D head shape of the skull. In conclusion, results reaffirmed the effectiveness of SAC as a treatment method for nonsyndromic single suture sagittal synostosis.
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Rodriguez-Florez et al. demonstrated significant three-dimensional calvarial growth following SMC.
“Rodriguez-Florez et al. demonstrated significant three-dimensional calvarial growth following this intervention, highlighting its potential in reshaping cranial morphology [62].”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [62]
Spring-assisted cranioplasty for sagittal synostosis facilitates three-dimensional calvarial growth.
“Rodriguez-Florez et al. demonstrated that spring-assisted cranioplasty for sagittal synostosis facilitates three-dimensional calvarial growth, leading to improved cranial shape and symmetry over time [62].”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [62]
Spring-assisted cranioplasty for sagittal synostosis leads to improved cranial shape and symmetry over time.
“Rodriguez-Florez et al. demonstrated that spring-assisted cranioplasty for sagittal synostosis facilitates three-dimensional calvarial growth, leading to improved cranial shape and symmetry over time [62].”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [62]
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- Authors
- Rodriguez-Florez, N., Borghi, A., Yauwan, D. D., Heuntinck, P., Bruse, J. L., Tenhagen, M., Göktekin, Ö. K., Angullia, F., Schievano, S., Dunaway, D. J., Jeelani, N. U. O., & James, G.
- Affiliations
- Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK
- Great Ormond Street Hospital (GB)
- Queen Mary University of London (GB)
- Vicomtech (ES)
- Corresponding author
- Borghi, Alessandro
- Yauwan, Daniel D.
- Tenhagen, Maik
- Göktekin, Özge K.
- Angullia, Freida
- Schievano, Silvia
- Dunaway, David J.
- James, Greg
- Venue
- Journal of Craniofacial Surgery
- Published
- 2020-08-13
- Volume
- 31
- Issue
- 7
- Pages
- 2084-2087
- ISSN
- 1049-2275 (ISSN-L)
- 1536-3732
- OpenAlex
- W3049598917
- Cited by
- 12
- References
- 18
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 3
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- Licence
- cc-by
- Locations
- Journal of Craniofacial Surgery (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Durham Research Online (Durham University) (submittedVersion, cc-by)
- Funders
- Medical Research Council (MR/T005297/1)
- Engineering and Physical Sciences Research Council (EP/N02124X/1)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
- Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Keywords
- sagittal synostosis, head shape, cephalic index, statistical shape models, infant skull, nonsyndromic craniosynostosis
- MeSH terms
- Craniosynostoses, Craniotomy, Female, Head, Humans, Infant, Male, Postoperative Period, Skull, Surgical Equipment, Plastic Surgery Procedures, Imaging, Three-Dimensional
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