Spring Cranioplasty for the Fused Lambdoid and Coronal Sutures: Expanding Indications

Abstract

Spring cranioplasty, originally developed for sagittal synostosis, has expanded to address selected lambdoid and coronal deformities by applying continuous mechanical distraction to gradually expand the cranium while avoiding the extensive dissection required for open vault remodeling. This chapter reviews the rationale, surgical technique, and outcomes of spring-mediated correction for these indications. For unilambdoid synostosis, comparative data show shorter operative times and lower blood loss relative to cranial vault reconstruction. For coronal synostosis, spring-assisted approaches offer reduced operative morbidity relative to fronto-orbital advancement, although limited control over final orbital position remains a notable trade-off. In both indications, a required second surgery for spring removal remains an inherent limitation. Our institutional experience, including virtual surgical planning to optimize spring placement and vector control, is presented alongside illustrative cases. As evidence for these non-sagittal applications continues to grow, larger comparative studies are needed to better define indications, refine surgical technique, and evaluate long-term outcomes.