Clinical efficacy of cryopreserved autologous bone flaps versus titanium plates for cranioplasty: A retrospective comparative study

Aim To compare the clinical efficacy and safety of cryopreserved autologous bone flaps versus titanium plates for cranioplasty in patients with cranial defects.Methods Sixty patients with cranial defects admitted to our hospital from January 2021 to June 2024 were retrospectively selected. They were assigned to the autologous bone group (n = 30, cranioplasty with cryopreserved autologous bone flaps) and the titanium plate group (n = 30, cranioplasty with titanium plates) according to the reconstruction material. The perioperative indicators, outcome for cranioplasty, neurological function recovery, incidence of complications, and treatment costs were compared between the two groups.Results The autologous bone group exhibited significantly better outcomes for cranioplasty at 3 and 6 months postoperatively than the titanium plate group (P < 0.05). At 6 months postoperatively, the autologous bone group exhibited significantly higher NIHSS scores than the titanium plate group (P < 0.05). The intracranial pressure levels were significantly lower at all postoperative time points in the autologous bone group than in the titanium plate group (P < 0.05). The autologous bone group demonstrated faster recovery of inflammatory indicators, lower overall incidence of complications (6.67% vs. 30.00%) (χ2=4.588, P = 0.032), and lower hospitalization costs and material expenses than the titanium plate group (P < 0.05).Conclusion Cryopreservation of autologous bone flaps for cranioplasty is associated with improved bone healing, better neurological recovery, reduced complication rates, and lower medical costs. However, these observational findings require further validation through prospective randomized controlled trials. Nevertheless, the current evidence supports the potential clinical application of this technique when feasible.