A unique operation to eliminate an extensive skull defect resulting from an injury was carried out at the EMC

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A unique operation to eliminate an extensive skull defect resulting from an injury was carried out at the EMC


An innovative technology CustomBone was applied in the surgery. The implant is a complete imitation of human bone in terms of mineral composition.
It was the first operation to be performed on an adult patient in Russia. (A similar operation was first performed on a child in January 2015). An individually tailored prosthesis of bioceramic material (porous hydroxyapatite) was installed, which is not perceive by the organism as a foreign body. It promotes the growth of bone cells and further natural regeneration of the skull after the intervention.
International clinical studies have shown, colonization of prosthetic bone cells, prosthesis ossification and subsequent natural growth and restoration of the cranium occurring in the patients who have undergone a similar cranioplasty.
Professor, MD, Director of the EMC Neurosurgery Clinic, Alexey Krivoshapkin, MD : "This case is a rare event in our practice. A patient suffering from a chronic disease and treated by neurologists, was trying rehabilitation independently in home environment, underwent a severe head injury that required a complex surgery and a long stay in the intensive care unit. A life-saving surgery -a decompressive skull trephination with removal of bone flap was performed. Fortunately, as a result of the treatment and rehabilitation the patient has fully recovered and returned to normal life and challenging intellectual work, which he had done prior to the surgery.
A few months later, an issue of closing the skull defect recovery arose. Besides, the primary injury resulted over time in the development of a dural arteriovenous malformation and anarteriovenous fistula of the scalp (abnormalcommunication between the arteries and veins), which were confirmed by angiographic studies. During the surgery the fistula of the scalp, causing the constant intense sound in the head was closed, and simultaneously the defect of the skull was closed as well.
We have performed the closure of the defect with an unusual material, which over time will be replaced with the patient’s own bone tissue. The patient will be observed by neurologists about the chronic disease, he will need multiple tomographic studies, so it was essential for us to restore the natural bone. The implant is made in precise accordance with the skull defect configurations, the patient initially underwent a multislice x-ray computer tomography as a basis for the restoration of the contours, and the implant was manufactured. Along with cosmetic effect it has had a therapy value for the patient.
Opportunities of navigation technologies, intraoperative video-angiography, microsurgery, which have been implemented at the EMC, enable surgeries of any complexity to save the lives and quality of life for our patients. "
The EMC Clinic of Neurosurgery and Neurology provides surgical treatment of most diseases of the nervous system, including benign and malignant tumors of the brain, spinal cord, peripheral nerves, epilepsy, brain and spinal cord injuries. Thanks to the principle of minimal invasiveness, in most cases patients with brain and spinal cord diseases can be returned to active life. In particular, a complete removal of the tumor in more than 2/3 patients with glioma is possible, the lethality of removing malignant brain tumors is 0%, the risk of preserving a persistent pain after the removal of disk hernias is not more than 2.5%.

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