Medical Student Vanderbilt University School of Medicine Nashville, Tennessee, United States
Introduction: Cranioplasty is a common neurosurgical procedure which can be performed with different materials causing potentially large variations in incurred direct cost of the procedure. The extant literature on cranioplasty costs is limited. Our aim is to review the current literature of cranioplasty costs across the different common cranioplasty modalities.
Methods: A systematic review of the literature for cost of cranioplasty was conducted in accordance with the PRISMA guidelines. Studies from all countries were considered. Historical currency exchange rates provided by OANDA were used to convert to a common denominational currency for this study, dollars. If native exchange rates were provided in the article, the rate was used. Cost was corrected for inflation using the US Bureau of Labor Statistics Inflation Calculator, correcting to April 2022.
Results: Of 363 articles, 10 articles were included in the final analysis. The included articles (2014 to 2022) originated most from the United States (n=5) and Canada (n=2). 8 (80%) of the studies were single-center studies, 1 (10%) was a multi-center study, and 1(10%) was a population-level study (patient number rage 9 – 8275). The currency-corrected and inflation corrected range of mean cost for autologous implants was $465.82 to $60,860.26 (n=9), $13,876.61 to $40,011.35 (n=3) for titanium, $23,911.30 to $73,736.23 (n=4) for polyether ether ketone (PEEK), $8,937.04 to $22,764.90 (n=2) for polymethyl methacrylate (PMMA), and $33,604.96 (n=1) for custom computer-generated implants (CCGI). In terms of cost reporting, of the 10 articles, 8 (80%) of them separated out the cost elements. Of the 8 that separated cost elements, 8 (100%) reported direct costs, and 5 (62.5%) reported indirect costs.
Conclusion : Understanding costs related to cranioplasty is important for health care systems and patients alike. This study underscores the paucity of literature regarding cranioplasty cost and the current wide range of costs related to this operation.
