The dura split technique in the treatment of craniosynostosis:is it still an option?

Abstract Background: The aim of this study was to report the outcome and the complications for patients operated on for craniosynostosis using the dura split technique. Specifically, the authors aimed to evaluate the safety of this technique, which is currently not in use, and to determine whether it is still useable. Methods: The data was collected from the hospital patient records of all children surgically treated for craniosynostosis using the dura split technique in Turku University Hospital during the period 1975 to 2015. The data was analyzed to determine the clinical and radiological outcomes of the surgical procedure, the need for reoperations, and the rate of complications. Results: During the study period, the dura split technique was used in the surgery of 65 patients. The outcome was either good or acceptable in most patients and reoperation was needed in only 2 patients (3.1%). Surgical complications included significant blood loss (26.2%), lesions on the inner layer of the dura (21.5%), leakage of cerebrospinal fluid (13.8%), and persistent bone defects (15.4% on palpation and 63.1% radiologically). Conclusions: Although the outcome of surgery for craniosynostosis using the dura split technique was mostly acceptable and the need for reoperations rare, the technique cannot, however, be recommended in the future due to high rates of bone defects, frequent problems with lesions on the inner layer of the dura, and consequent perioperative leakage of cerebrospinal fluid