Posterior cranial vault distraction

Posterior cranial vault distraction (age: 6-12 months)

The posterior cranial vault distraction is a surgical procedure that expands the back of the skull, cutting and gradually stretching the bone and skin to expand the intracranial space and create new bone.

The distraction technique has replaced the traditional fronto-orbital advancement procedure as the most common initial treatment used to expand the skull in patients with syndromic craniosynostosis. The posterior vault distraction offers several advantages. Distraction expands the soft tissue in addition to the bone, allowing for significantly greater expansion of your child’s skull. This is especially useful if your child has elevated intracranial pressure or a very abnormal head shape.

In the posterior cranial vault distraction procedure, a coronal (ear-to-ear) incision is made, the posterior skull is exposed, and cuts are made around the bone to be expanded. Metallic distractors are then placed along your child’s bone and the incision is closed. The distractors work to slowly stretch and expand the bone and surrounding tissues.

Starting three to five days after the procedure, your child’s surgeon will begin turning the distractors. Over the next two to three weeks, gradual expansion of the bone and soft tissue occurs.

The operation typically lasts approximately two and three hours. You can expect your child to remain in the hospital post-surgery for an average of two to three days. This procedure may be repeated between 2 and 5 years of age if your child has continued growth restriction or abnormal skull growth.

The posterior cranial vault distraction is less invasive than a formal open vault expansion, and allows for more significant expansion of the bone and soft tissue.