Surgical procedures
Minimally invasive procedure for sagittal suture synostosis – implanted titanium springs use skull growth actively.
Spring-assisted cranioplasty (spring-assisted strip craniectomy, SASC) is a minimally invasive procedure for sagittal suture synostosis. In a small operation the prematurely fused suture is opened and two elastic titanium springs are implanted immediately afterwards. These create continuous spreading pressure and actively use the rapid skull growth of the infant to gradually reshape the skull cross-section towards a normal oval form.
Once the target correction is reached, the springs are removed in a second small procedure.
Through two small incisions the ossified sagittal suture is removed (strip craniectomy). Through the same accesses two titanium springs are placed symmetrically on either side of the midline. Duration: approx. 1–1.5 hours; postoperative intensive-care stay usually only 24 hours or less. After 4–6 months the springs are removed in a second short procedure.
| Spring cranioplasty | Open CVR | |
|---|---|---|
| Age | 3–6 months | 6–12 months |
| Accesses | 2 small incisions | Bicoronal |
| Blood loss | Low | Higher (transfusion often) |
| Number of procedures | 2 (placement + removal) | 1 |
| Shape control | Springs + growth | Fully surgical |
| Complex forms | Limited | Better suited |
Studies show comparable morphological results between spring cranioplasty and open CVR for sagittal synostosis, with markedly less blood loss and shorter intensive care. The technique requires experience in spring positioning and a consistent monitoring protocol.
After the affected suture is opened, springs are inserted that gently reshape the skull over several weeks. A second small procedure removes the springs.
It is an option for certain forms and age groups. Suitability is assessed individually at the specialist centre.