Abstract：
Three-dimensionally (3D) printed polyether-ether-ketone (PEEK) implants are a relatively novel option for cranioplasty that have recently gained popularity. However, there is ongoing debate with respect to material efficacy and safety compared to autologous bone grafts. The purpose of this study was to offer our institution\'s experience and add to the growing body of literature.
A single-institution retrospective analysis of patients undergoing cranioplasties between 2016 and 2021. Patients were divided into PEEK and autologous cranioplasty cohorts. Parameters of interest included patient demographics as well as perioperative (<3 months postoperative) and long-term outcomes (>3 months postoperative). A P value < 0.05 was considered statistically significant.
A total of 31 patients met inclusion criteria (PEEK: 15, Autologous: 16). Mean age of total cohort was 48.9 years (range 19-82 years). Modified Frailty Index (mFI) revealed greater rate of comorbidities among the Autologous group (P = 0.073), which was accounted for in statistical analyses. Multiple logistic regression model revealed significantly higher rate of surgical site infection in the Autologous cohort (31.3% vs. 0%, P = 0.011). Minor complications were similar between groups, while the Autologous group experienced significantly more major postoperative complications (50%) versus PEEK (13.3%) (P = 0.0291). Otherwise perioperative and long term complication profiles were similar between groups. Additionally, generalized linear model demonstrated both cohorts had similar mean hospital length of stay (LoS) (Autologous: 16.1 vs. PEEK: 10.7 days).
PEEK cranioplasty implants may offer more favorable perioperative complication profiles with similar long-term complication rates and hospital LoS compared to autologous bone implants. Future studies are warranted to confirm our findings in larger series, and further examine the utility of PEEK in cranioplasty.
A single-institution retrospective analysis of patients undergoing cranioplasties between 2016 and 2021. Patients were divided into PEEK and autologous cranioplasty cohorts. Parameters of interest included patient demographics as well as perioperative (<3 months postoperative) and long-term outcomes (>3 months postoperative). A P value < 0.05 was considered statistically significant.
A total of 31 patients met inclusion criteria (PEEK: 15, Autologous: 16). Mean age of total cohort was 48.9 years (range 19-82 years). Modified Frailty Index (mFI) revealed greater rate of comorbidities among the Autologous group (P = 0.073), which was accounted for in statistical analyses. Multiple logistic regression model revealed significantly higher rate of surgical site infection in the Autologous cohort (31.3% vs. 0%, P = 0.011). Minor complications were similar between groups, while the Autologous group experienced significantly more major postoperative complications (50%) versus PEEK (13.3%) (P = 0.0291). Otherwise perioperative and long term complication profiles were similar between groups. Additionally, generalized linear model demonstrated both cohorts had similar mean hospital length of stay (LoS) (Autologous: 16.1 vs. PEEK: 10.7 days).
PEEK cranioplasty implants may offer more favorable perioperative complication profiles with similar long-term complication rates and hospital LoS compared to autologous bone implants. Future studies are warranted to confirm our findings in larger series, and further examine the utility of PEEK in cranioplasty.
摘要：
目的：三维（3D）打印的聚醚醚酮（PEEK）植入物是颅骨成形术的一种相对新颖的选择，最近受到了欢迎。然而,与自体骨移植相比，在材料功效和安全性方面存在持续的争论。这项研究的目的是提供我们机构的经验，并增加日益增长的文学。
方法：对2016年至2021年接受颅骨成形术的患者进行单机构回顾性分析。患者分为PEEK和自体颅骨修补术组。感兴趣的参数包括患者的人口统计学以及围手术期(术后<3个月)和长期结果(术后>3个月)。P值<0.05被认为是统计学上显著的。
结果：共有31例患者符合纳入标准（PEEK：15，自体：16）。总队列的平均年龄为48.9岁（范围19-82岁）。改良的虚弱指数（mFI）显示，自体组合并症的发生率更高（P=0.073），这在统计分析中得到了解释。多元logistic回归模型显示，自体队列中手术部位感染率明显较高(31.3%vs.0%,P=0.011)。两组之间的轻微并发症相似，与PEEK（13.3％）相比，自体组的主要术后并发症（50％）明显更多（P=0.0291）。两组之间的围手术期和长期并发症情况相似。此外,广义线性模型表明，两个队列的平均住院时间(LoS)相似(自体：16.1vs.PEEK：10.7天）。
结论：与自体骨植入物相比，PEEK颅骨修补术植入物可提供更有利的围手术期并发症，长期并发症发生率和医院LoS相似。未来的研究有必要在更大的系列中证实我们的发现，并进一步检查PEEK在颅骨修补术中的实用性。
方法：对2016年至2021年接受颅骨成形术的患者进行单机构回顾性分析。患者分为PEEK和自体颅骨修补术组。感兴趣的参数包括患者的人口统计学以及围手术期(术后<3个月)和长期结果(术后>3个月)。P值<0.05被认为是统计学上显著的。
结果：共有31例患者符合纳入标准（PEEK：15，自体：16）。总队列的平均年龄为48.9岁（范围19-82岁）。改良的虚弱指数（mFI）显示，自体组合并症的发生率更高（P=0.073），这在统计分析中得到了解释。多元logistic回归模型显示，自体队列中手术部位感染率明显较高(31.3%vs.0%,P=0.011)。两组之间的轻微并发症相似，与PEEK（13.3％）相比，自体组的主要术后并发症（50％）明显更多（P=0.0291）。两组之间的围手术期和长期并发症情况相似。此外,广义线性模型表明，两个队列的平均住院时间(LoS)相似(自体：16.1vs.PEEK：10.7天）。
结论：与自体骨植入物相比，PEEK颅骨修补术植入物可提供更有利的围手术期并发症，长期并发症发生率和医院LoS相似。未来的研究有必要在更大的系列中证实我们的发现，并进一步检查PEEK在颅骨修补术中的实用性。
