Clinical outcomes and material-selection considerations for titanium mesh and patient-specific polyetheretherketone cranioplasty: a retrospective cohort study
- 1Department of Emergency, The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine , , ,
- 2Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University , ,
Abstract
Objective: To compare outcomes after titanium mesh and patient-specific polyetheretherketone (PEEK) cranioplasty and to interpret the findings in the context of material-specific clinical indications.
Methods: We retrospectively analyzed 99 patients who underwent cranioplasty over four years with either titanium mesh (n = 60, 60.6%) or patient-specific PEEK implants (n = 39, 39.4%). Available demographic, operative, neurological, cognitive, postoperative inflammatory, temperature, and complication data were compared. Preoperative inflammatory markers, estimated blood loss, transfusion, and standardized patient-satisfaction outcomes were not consistently available.
Results: The groups differed in age and comorbidity burden (both p < 0.01) but not in sex, defect-diameter category, or operative duration. NIHSS, GOS, and MMSE scores did not change significantly within the titanium group. Within the PEEK group, NIHSS and GOS did not change significantly, whereas MMSE increased at 3 months ( p = 0.005). The complication-free proportion was 41.7% in the titanium group and 64.1% in the PEEK group (unadjusted p = 0.029). Mean temperature during the first three postoperative days was 37.17 ± 0.36 °C in the titanium group and 36.91 ± 0.31 °C in the PEEK group ( p < 0.01). These comparisons were unadjusted and do not establish causality.
Conclusion: In this retrospective cohort, PEEK was associated with fewer recorded postoperative complications and lower mean postoperative temperature, while MMSE improved within the PEEK group. These unadjusted findings do not establish universal material superiority. Implant selection should be individualized according to defect size and geometry, anatomical location, soft-tissue condition, prior infection or implant failure, cosmetic requirements, availability, and cost.
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BibTeX
@article{wang2026clinical,
title = {{Clinical outcomes and material-selection considerations for titanium mesh and patient-specific polyetheretherketone cranioplasty: a retrospective cohort study}},
author = {Wei Wang and Shilin Liu and Yifan Fu and Xiaoxuan Li and Minghao Xu and Xiaochan Xu and Tao Jiang},
journal = {Frontiers in neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1725628},
url = {https://europepmc.org/article/PMC/PMC13672229},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical outcomes and material-selection considerations for titanium mesh and patient-specific polyetheretherketone cranioplasty: a retrospective cohort study
AU - Wei Wang
AU - Shilin Liu
AU - Yifan Fu
AU - Xiaoxuan Li
AU - Minghao Xu
AU - Xiaochan Xu
AU - Tao Jiang
PY - 2026
DA - 2026/10/02
JO - Frontiers in neurology
DO - 10.3389/fneur.2026.1725628
UR - https://europepmc.org/article/PMC/PMC13672229
AB - Objective: To compare outcomes after titanium mesh and patient-specific polyetheretherketone (PEEK) cranioplasty and to interpret the findings in the context of material-specific clinical indications. Methods: We retrospectively analyzed 99 patients who underwent cranioplasty over four years with either titanium mesh (n = 60, 60.6%) or patient-specific PEEK implants (n = 39, 39.4%). Available demographic, operative, neurological, cognitive, postoperative inflammatory, temperature, and complication data were compared. Preoperative inflammatory markers, estimated blood loss, transfusion, and standardized patient-satisfaction outcomes were not consistently available. Results: The groups differed in age and comorbidity burden (both p < 0.01) but not in sex, defect-diameter category, or operative duration. NIHSS, GOS, and MMSE scores did not change significantly within the titanium group. Within the PEEK group, NIHSS and GOS did not change significantly, whereas MMSE increased at 3 months ( p = 0.005). The complication-free proportion was 41.7% in the titanium group and 64.1% in the PEEK group (unadjusted p = 0.029). Mean temperature during the first three postoperative days was 37.17 ± 0.36 °C in the titanium group and 36.91 ± 0.31 °C in the PEEK group ( p < 0.01). These comparisons were unadjusted and do not establish causality. Conclusion: In this retrospective cohort, PEEK was associated with fewer recorded postoperative complications and lower mean postoperative temperature, while MMSE improved within the PEEK group. These unadjusted findings do not establish universal material superiority. Implant selection should be individualized according to defect size and geometry, anatomical location, soft-tissue condition, prior infection or implant failure, cosmetic requirements, availability, and cost.
SN - 1664-2295
ER -