Pediatric cranial vault distraction osteogenesis (DO)

What is a pediatric cranial vault distraction osteogenesis (DO) procedure?

The goal of distraction osteogenesis (DO) is to make bones longer. The surgery uses the body’s ability to heal bones to generate new bone where it is needed. During distraction osteogenesis (DO), a cut is made through the bone and a special device called a distractor is applied to the bone and the skin is closed.

After a brief time allowing healing to of the bone to begin, the cut ends are gradually separated from one by turning the distractor. New bone tissue forms between the cut ends as they are moved away from one another. The ends are separated to the desired length and then distraction is stopped and the new bone tissue matures and hardens.

What are the benefits of a pediatric cranial vault distraction osteogenesis (DO) procedure?

Distraction osteogenesis (DO) in the cranial vault has several advantages over single-stage reconstructive procedures.

These benefits include:

• Production of new bone
• Gradual stretching of the skin and muscle over the bone
• Larger increases of the space inside the skull for the brain to grow into.
• Greater overcorrection in head shape

The gradual stretching of the scalp allows greater movements of the skull bones to be achieved and maintained compared to operations that expand the skull in one step. In our experience, distraction osteogenesis (DO) provides twice as much expansion of the space inside the skull as single-stage operations.

Distraction procedures are better for global changes in the size and shape of the skull. It is most commonly used for expansion of the back of the skull, or the forehead together with the middle portion of the face (monobloc). This is usually the first surgery we perform in patients with syndromic craniosynostosis. 

What are the risks of a pediatric cranial vault distraction osteogenesis (DO) procedure?

Distraction osteogenesis (DO) does have its disadvantages as well.

These include:

• A brief second operation to remove the distraction devices
• Risk of breakage of the device
• Infection of the skin at the device site.
• Overall treatment tends to take longer, eight to 12 weeks.