Skip to main content

Research Repository

Advanced Search

Spring-assisted posterior vault expansion: a parametric study to improve the intracranial volume increase prediction

Deliège, Lara; Ramdat Misier, Karan; Silva, Dulanka; James, Gregory; Ong, Juling; Dunaway, David; Jeelani, Noor Ul Owase; Schievano, Silvia; Borghi, Alessandro

Spring-assisted posterior vault expansion: a parametric study to improve the intracranial volume increase prediction Thumbnail


Lara Deliège

Karan Ramdat Misier

Dulanka Silva

Gregory James

Juling Ong

David Dunaway

Noor Ul Owase Jeelani

Silvia Schievano


Spring-assisted posterior vault expansion has been adopted at the London Great Ormond Street Hospital for Children to treat raised intracranial pressure in patients affected by syndromic craniosynostosis, a congenital calvarial anomaly causing the premature fusion of skull sutures. This procedure involves elastic distractors used to dynamically reshape the skull and increase the intracranial volume (ICV). In this study, we developed and validated a patient-specific model able to predict the ICV increase and carried out a parametric study to investigate the effect of surgical parameters on that final volume. Pre- and post-operative computed tomography data relative to 18 patients were processed to extract simplified patient-specific skull shape, replicate surgical cuts, and simulate spring expansion. A parametric study was performed to quantify each parameter’s impact on the surgical outcome: for each patient, the osteotomy location was varied in a pre-defined range; local sensitivity of the predicted ICV to each parameter was analysed and compared. Results showed that the finite element model performed well in terms of post-operative ICV prediction and allowed for parametric optimization of surgical cuts. The study indicates how to optimize the ICV increase according to the type of procedure and provides indication on the most robust surgical strategy.

Journal Article Type Article
Acceptance Date Nov 22, 2023
Online Publication Date Dec 4, 2023
Publication Date 2023
Deposit Date Dec 7, 2023
Publicly Available Date Dec 7, 2023
Journal Scientific Reports
Publisher Nature Research
Peer Reviewed Peer Reviewed
Volume 13
Issue 1
Article Number 21371
Public URL


Published Journal Article (1.4 Mb)

Publisher Licence URL

Copyright Statement
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit

You might also like

Downloadable Citations