Spring-Mediated Cranioplasty for Treatment of Sagittal Synostosis

Nonsyndromic sagittal craniosynostosis (SCS) leads to a head shape that is unusually long and narrow. Primary surgical treatments for SCS are generally categorized into two main groups: open cranial vault remodeling (CVR), which is typically used in older children, and early intervention with less-invasive approaches. Although these methods differ significantly, they share common objectives, specifically to normalize cranial appearance and to prevent future neurocognitive problems. CVR is usually performed after 6 months of age through an open bicoronal approach, where the affected part of the skull is removed and reshaped during the surgery. While CVR offers immediate and reliable results, it comes with risks such as significant blood loss during surgery, larger scars, the need for postoperative intensive care, and longer hospital stays. To mitigate these issues, less-invasive alternatives have been developed. These involve surgically “releasing” the sagittal suture, followed by reshaping the skull postoperatively with either an external cranial orthosis, such as a helmet, or, more recently, internal distractor springs, which will be the focus of this chapter.