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Russian Neurosurgical Journal named after Professor A. L. Polenov

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Long-term results of allocranioplasty using individual biopolymer osteointegrable implants made of “Recost-M” material

https://doi.org/10.56618/2071-2693_2024_16_2_6

EDN: QCDTXS

Abstract

INTRODUCTION. The restoration of defects in the bones of the cranial vault remains an urgent task to this day, since it is necessary to prevent the development of post-trepanation syndrome. When using various materials for cranioplasty (titanium, PEEK, hydroxyapatite, etc.), the incidence of infectious complications ranges from 6.02 to 21.03 %, and they do not undergo osseointegration. For allocranioplasty with individual implant manufacturing using 3D modeling, a domestic bone replacement material biopolymer “Recost-M” has been developed and used, the ability of which to osseointegration has already been proven.

AIM. To assess the degree of osseointegration of an allograft from the “Recost-M” biopolymer in patients after its implantation in the long-term postoperative period.

MATERIALS AND METHODS. From 2017 to 2023, 27 cranioplasty operations were performed in adult patients at RostSMU. Among them, men – 16, women – 11. The average size of the defect of the bones of the cranial vault in men is 110.4±32.5 cm2, in women – 85.7±37.8 cm2. The implant made of “Recost-M” biopolymer using 3D modeling was fixed with craniofixes from any manufacturer, or with bone sutures at three or four fixation points. In all cases, when the skin-aponeurotic flap was detached, the integrity of the dura mater was preserved in order to avoid possible complications, such as accumulation of cerebrospinal fluid under the implant, cerebrospinal fluid, infection of the implant. In the neurosurgical department of the Republican Children’s Clinical Hospital of Ufa (NHO RDKB), the possibility of reconstructing skull defects using the material was studied “Recost-M” in 16 children aged 2 to 6 years.

RESULTS. During the entire observation period, infectious complications and trophic disorders of the skin-aponeurotic flap and implant depressurization, which may lead to implant removal, were not observed in all clinical observations. 5 years after allocranioplasty by CT scan of the brain in adult patients, signs of osseointegration of the implant from the biopolymer “RecostM” in the form of calcinate inclusions into the porous structure of “Recost-M” were revealed. There were no complications during the plastic surgery of skull defects in children with the domestic material “Recost-M” during the follow-up in the longterm period.

CONCLUSION. The obtained results of using an allograft from the “Recost-M” biopolymer showed both the absence of complications in the early postoperative period and the presence of osteointegration of the biopolymer in the long-term postoperative period, which indicates its advantage over existing titanium implants. And in the context of the need for import substitution, a biopolymer of domestic development is competitive and can be recommended for more frequent use in pediatric neurosurgical practice.

About the Authors

I. V. Balyazin-Parfenov
Rostov State Medical University
Russian Federation

Igor V. Balyazin-Parfenov – Dr. of Sci. (Med.), Professor at the Department of Neurology and Neurosurgery

29 Nakhichevansky Lane, Rostov-on-Don, 344022



V. A. Balyazin
Rostov State Medical University
Russian Federation

Viktor A. Balyazin – Dr. of Sci. (Med.), Full Professor, Head at the Department of Neurology and Neurosurgery

29 Nakhichevansky Lane, Rostov-on-Don, 344022



V. D. Zaitsev
Rostov State Medical University
Russian Federation

Vitaly D. Zaitsev – Postgraduate Student at the Department of Neurology and Neurosurgery

29 Nakhichevansky Lane, Rostov-on-Don, 344022



G. A. Bulguryan
Rostov State Medical University
Russian Federation

Grigory A. BulguryanResident at the Department of Neurology and Neurosurgery

29 Nakhichevansky Lane, Rostov-on-Don, 344022



I. V. Uspenskiy
AIKON LAB GMBH Limited Liability Company
Russian Federation

Igor V. Uspenskiy – Chief Specialist

a/z 27, Nizhny Novgorod, 603003



A. G. Timershin
Republican Children’s Clinical Hospital
Russian Federation

Ayrat G. Timershin – Cand. of Sci. (Med.), Head at the Department of Neurosurgery

98 Stepan Kuvykin street, Ufa, 450106



References

1. Scerrati A., Travaglini F., Gelmi C. A. E. et al. Patient specific Polymethyl methacrylate customised cranioplasty using 3D printed silicone moulds: Technical note. Int. J. Med. Robot. 2022;18(2):e2353. Doi: 10.1002/rcs.2353.

2. Morselli C., Zaed I., Tropeano M. P. et al. Comparison between the different types of heterologous materials used in cranioplasty: a systematic review of the literature. J. Neurosurg. Sci. 2019;63(6):723–736. Doi: 10.23736/S0390-5616.19.04779-9.

3. Kolmogorov Yu. N., Uspensky I. V., Maslov A. N. et al. Rekost-M bone replacement implants based on 3D modeling for closing post-craniotomy skull defects: preclinical and clinical studies. Modern technologies in medicine. 2018;10(3):95–103. (In Russ.)]. Doi: 10.17691/stm2018.10.3.11. EDN: YLLJMT.

4. Dyusembekov E. K., Isataev B. S., Sadykova Zh. B. et al. Cranioplasty: using 3D implants for repair skull defect. Vestnik KazNMU. 2016;(4):82–92. (In Russ.)]. EDN: YOEUJU.

5. Patent RU No. 2518753. Filler material inventor / Kolmogorov Yu. N., Uspenskiy I. V., Slinyakov A. Yu., Novikov A. E. 10.06.2014. (In Russ.)].

6. Komar V. V., Yaroshchik T. M., Dudich O. N. et al. A clinical case of a combined approach to restoring post-traumatic deformation of the bones of the arch and base of the skull, bones of the middle zone of the face. Nejrohirurgiâ. 2022;24(4):67– 72. (In Russ.)]. Doi: 10.17650/1683-3295-2022-24-4-6772. EDN: FBJMJO.

7. Kravchuk A. D., Potapov A. A., Panchenko V. Ya. et al. Additive technologies in neurosurgery. Voprosy Neirokhirurgii imeni N. N. Burdenko. 2018;82(6):97–104. (In Russ.)]. Doi: 10.17116/neiro20188206197. EDN: YVXDSH.

8. Chobulov S. A., Kravchuk A. D., Potapov A. A. et al. Modern aspects of reconstructive surgery of skull defects. Voprosy Neirokhirurgii imeni N. N. Burdenko. 2019;83(2):115–124. (In Russ.)]. Doi: 10.17116/neiro201983021115. EDN: RDASUM.

9. Sharobaro V. I., Potapov A. A., Gavrilov A. G. et al. The choice of reconstruction method for extensive combined cranial defects depending on the clinical situation. Annaly plasticheskoi, rekonstruktivnoi i esteticheskoi khirurgii. 2018;(1):111–112. (In Russ.)]. EDN: XMHUKT


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For citations:


Balyazin-Parfenov I.V., Balyazin V.A., Zaitsev V.D., Bulguryan G.A., Uspenskiy I.V., Timershin A.G. Long-term results of allocranioplasty using individual biopolymer osteointegrable implants made of “Recost-M” material. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2024;16(2):6-15. (In Russ.) https://doi.org/10.56618/2071-2693_2024_16_2_6. EDN: QCDTXS

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ISSN 2071-2693 (Print)