Decompressive craniectomy is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure (ICP). Raised intracranial pressure is very often debilitating or fatal because it causes compression of the brain and restricts cerebral blood flow. The aim of decompressive craniectomy is to reduce this pressure. The part of the skull that is removed is called a bone flap. A study has shown that the larger the removed bone flap is, the more ICP is reduced. After a craniectomy, the risk of brain injury is increased, particularly after the patient heals and becomes mobile again. Therefore, special measures must be taken to protect the brain, such as an implant in the skull.
Cranioplasty is a surgical repair of a defect or deformity of a skull. Cranioplasty has been performed for ages. There is evidence that Incan and Muisca surgeons were performing cranioplasty using precious metals and gourds. The precious metallic bone substitutes have largely been replaced by modern plastics. Poly(methyl methacrylate) (PMMA) was introduced in 1940 and is currently the most common material used. The excellent biocompatibility and other favorable properties of Titanium has made it a common Cranioplasty material recently. The aim of cranioplasty is not only a cosmetic issue; also, the repair of cranial defects gives relief to psychological drawbacks and increases the social performances. Moreover, the incidence of epilepsy is shown to be decreased after cranioplasty. With decompressive craniectomy for ischemic stroke, traumatic brain injury, and skull-infiltrating tumors, the need for cranioplasty has increasedFew indications for cranioplasty are mentioned below
Autograft Cranioplasty is a Cranioplasty procedure in which the patient sown bone is used to cover the defect. Usually the cranial flap/bone which was removed during Craniotomy is used to close the cranial void. Usually Craniplasty is advised after a minimum of 2 to 3 month gap after Craniectomy. During this period, the cranial flap has to be preserved and protected. Many techniques are used to maintain the is autograft bone flap during this waiting period. Westerman proposed to use craniotomy materials after boiling in water. But after high infection rates, this method was abandoned. Another method is autoclaving to prevent infections. However, it was seen that the bone could not keep its viability after autoclaving in most cases. The most recent method to protect autografts is to freeze the bones. Dry freeze in -70°C is an accepted way to keep bone flaps sterile and ready to use. This technique keeps the matrix architecture of bone intact and ready to use. But this technique does not prevent the bone from “dying.” Saving the craniotomy flap in the fatty tissue of the abdomen was first described by Kreider in 1920. This method is no more as popular as it was first described, because the need for a second surgery arises, the scar tissue in abdomen occurs, and osteogenic capacity of the bone is never as it is expected.
Osteomyelitis is an infection of the bone, a rare but serious condition. Bones can get infected in different ways. Infection that occurs in a different region can be carried by blood stream into the bone. Open fracture or surgery may expose bone to infection. In most cases the bacteria Staphylococcus Aureus cause it. Customised implants and instruments made by Medicad is being used to restore bone loss in several mandible Osteomyelitis surgeries.
Atlantoaxial Osteoarthritis is a metabolically active, dynamic process that involves all joint tissues such as cartilage, synovium/capsule, ligaments and muscles. It refers to a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life Atlantoaxial Osteoarthritis in elderly is most often a result of a degenerative disorder and in younger patients it is because of a trauma. The most clinical symptom of atlantoaxial osteoarthritis is unilateral occipitocervical pain aggravated by head rotation. The pain ascends unilaterally to the occiput, the parietal skull and in some cases even to the eye. Degenerative changes of atlantodens and atlanto-axial facet joints can contribute to pain, and motion and sensory limitations that increase exponentially with age. Atlantoaxial transarticular screw fixation is an effective technique for this form of osteoarthritis. Surgical accuracy is critical due to the unique anatomy of the atlantoaxial region. Customized solution offers the best result for such osteoarthritis cases. Along with a 3D physical model of the patient, 3D printed guides and implant provided unmatched confort for the patient.
Craniofacial microsomia (CFM) is a term used to describe a spectrum of abnormalities that primarily affect the development of the skull (cranium) and face before birth. Microsomia means abnormal smallness of body structures. Most people with craniofacial microsomia have differences in the size and shape of facial structures between the right and left sides of the face (facial asymmetry). In about two-thirds of cases, both sides of the face have abnormalities, which usually differ from one side to the other. The most prominent feature of CFM is a predominantly unilateral hypoplasia of the mandible, leading to facial asymmetry. Customized solutions from Medicad Implants has been helping many patients with CFM regain their confidence by implanting Titanium and PMMA implants for such deformities.