D1.3 The use of spring technology in craniofacial surgery at gosh – from bedside to bench to bedside

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BackgroundSpring use in Craniofacial surgery was popularised by the Swedish Group led by Lauritzen, starting in 1997. We developed and pioneered the use of bespoke springs as an adjunct in our Craniofacial surgery programme in January 2008 and have since undertaken over 300 cases utilising some 800 springs; to our knowledge this constitutes the largest global experience of spring usage in Craniofacial surgery. The main indications are to augment posterior vault expansion procedures and the correction of scaphocephaly. We aim to provide a comprehensive overview of the use of biomechanical analysis in optimising clinical outcomes in spring assisted Craniofacial surgery.MethodsWe utilised a prefabricated standardised spring design which has allowed our group an unprecedented opportunity to study force vectors in vivo during the treatment cycles and their effect on the craniofacial morphology. Employing techniques of finite element modelling, statistical analyses, bone micro-architectural analyses, 3D photogrammetry and volumetric studies our group has been able to analyse this data to generate accurate paradigms for Spring use in this cohort of patients.ResultsWe are now able to predict with reasonable accuracy the post operative results of intervention utilising springs in cases of scaphocephaly using finite element modelling; a significant step forward for Craniofacial surgery programmes This information has been taken back to the bedside and guides our use of springs by defining the osteotomies, the size, position and number of springs for specific cases.The IP from the “GOSH Spring” experience has been acquired by KLS Martin, a global leader in surgical devices. Final clinical trials are ongoing with an international launch date of January 2018.ConclusionThis analysis has allowed us to understand the shortfalls with the current generation of springs and the programme is attempting to overcome some of these with the implementation of novel designs and materials.

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