Spring Assisted Cranioplasty

At UPMC Children's Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this surgery and invite you to participate. Please read the following information to learn about the surgery and how you can help.

What Is Spring Assisted Cranioplasty?

Sagittal craniosynostosis is the premature fusion or closure of the sagittal suture.

If the sagittal suture fuses in utero or early infancy, the head shape is long and narrow and there is a surgery called “spring assisted cranioplasty" that can be performed.

This is a cranial spring. This allows reshaping and expansion of skull to improve head shape and prevent pressure from developing.

Cranial Spring

This surgery is typically performed around 4 months of age.

It involves an incision where a strip of bone is removed where the suture has closed and hardware or springs go in place to help expand skull bones and create space.

The springs open out to widen this gap and new bone forms over the gap over the following months. Skin is closed with dissolvable sutures (do not need sutures removed).

Four months after the springs go in, the patient undergoes a 20-minute procedure to have them removed.

Before the Surgery

  • Discussion with surgeon, written surgical consent
  • Lab work
  • No non-steroidal anti-inflammatory drugs (NSAIDs) 2 weeks before the surgery, call with new onset illness. The most common NSAIDs are aspirin (like St. Joseph®), ibuprofen (Advil® or Motrin®), or naproxen sodium (Aleve®)

Home Preparation

The day before surgery (Friday if surgery is Monday) you will receive a call from Same Day Surgery letting you know what time the case starts and what time you need to be at the hospital as well as when you need to start nothing by mouth for anesthesia.

  • Typically you will receive a call between 1 and 7 p.m.
  • For GENERAL ANESTHESIA: NPO (Nothing by mouth) fulls/solids (this includes milk, candy, gum) AFTER midnight
  • Breastfed babies NPO 4 hours prior, plain breast milk
  • Clear liquids NPO 3 hours prior (clear liquids include water, apple juice, and Pedialyte®)
  • Plain formula NPO 6 hours prior, not thickened
  • No solids after midnight!

Day of Surgery

  • Park in Penn Garage and take the Grape elevator to the 4th floor to check in at Same Day surgery.
  • Arrival: 1.5 hours prior to surgery.
  • You will meet with nurse, your surgeons, and anesthesia. You will review consents.
  • Following surgery, the patient will go to a recovery area. Nurses will call you when they are ready for family.
  • Mom and dad can stay with patient overnight. No children may sleep over.

After Surgery

  • We typically get a skull X-ray prior to discharge.
  • There will be a white head dressing placed that will be removed two days after surgery.
  • Swelling and bruising is common after this surgery; it will improves over time.
  • The incision site should be cared for starting two days following surgery with normal bathing (no submerging) and one week of bacitracin antibiotic ointment application.

Going Home

  • Discharge from hospital is typically post operative day 1 or 2.
  • Babies should be tolerating their normal home bottle or breast feeds.
  • Most babies are off of all pain medication within one to two weeks of surgery.
  • Sometimes sleep pattern is affected and this should improve with time.
  • Incision is typically healed within two to three weeks of surgery, sutures dissolved.

At-Home Care

  • Follow up within 1-2 weeks

Special Needs

If your child has any special needs or health issues you feel the doctor needs to know about, or if you have any questions, please call 412-692-8650 before the surgery and ask to speak with the nurse practitioner or cleft clinic coordinator. It is important to notify us in advance about any special needs your child might have.