Comparisons of Intracranial Volume and Cephalic Index After Correction of Sagittal Craniosynostosis With Either Two or Three Springs.

ABSTRACT: In this retrospective study, the authors determined changes in intracranial volume (ICV) and cephalic index (CI) in patients with sagittal craniosynostosis and operated with craniotomy combined with either 2 or 3 springs. The authors included patients (n = 112) with complete follow-up that had undergone surgical correction for isolated sagittal craniosynostosis with craniotomy combined with springs between 2008 and 2017. All patients underwent computed tomography examination preoperative, at the time of spring extraction, and at 3 years of age. Intracranial volume was measured using a semiautomatic MATLAB program, and CI was calculated as the width/length of the skull. The authors found that craniotomy combined with 2 springs increased the ICV from a preoperative value of 792 ±â€Š113 mL (mean ±â€Šstandard deviation) to 1298 ±â€Š181 mL at 3 years of age and increased the CI from 72.1 ±â€Š4.1 to 74.6 ±â€Š4.3, whereas craniotomy combined with 3 springs increased the ICV from 779 ±â€Š128 mL to 1283 ±â€Š136 mL and the CI from 70.7 ±â€Š4.3 to 74.8 ±â€Š3.7. The relative increase in ICV was 65 ±â€Š21% in the two-spring group and 68 ±â€Š34% in the three-spring group (P value = 0.559), and the relative increase in CI was 3.6 ±â€Š3.3% in the two-spring group as compared with 6.0 ±â€Š5.0% in the three-spring group (P = 0.004). These findings demonstrated that use of 3 springs resulted in additional absolute and relative CI-specific effects as compared with 2 springs during the time when the springs were in place, with this effect maintained at 3 years of age.