Cranioplasty (CP) is a standard procedure in neurosurgical practice for patients after (decompressive) craniectomy. However, CP surgery is not standardized, is carried out in different ways, and is associated with considerable complication rates. Here, we report our experiences with the use of different CP materials and analyze long-term complications and implant survival rates. We retrospectively studied patients who underwent CP surgery at our institution between 2004 and 2014. Binary logistic regression analysis was performed in order to identify risk factors for the development of complications. Kaplan-Meier analysis was used to estimate implant survival rates. A total of 392 patients (182 females, 210 males) with a mean age of 48 years were included. These patients underwent a total of 508 CP surgeries. The overall complication rate of primary CP was 33.2%, due to bone resorption/loosening (14.6%) and graft infection (7.9%) with a mean implant survival of 120 ± 5 months. Binary logistic regression analysis showed that young age (< 30 years) (p = 0.026, OR 3.150), the presence of multidrug-resistant bacteria (p = 0.045, OR 2.273), and cerebrospinal fluid (CSF) shunt (p = 0.001, OR 3.137) were risk factors for postoperative complications. The use of titanium miniplates for CP fixation was associated with reduced complication rates and bone flap osteolysis as well as longer implant survival rates. The present study highlights the risk profile of CP surgery. Young age (< 30 years) and shunt-dependent hydrocephalus are associated with postoperative complications especially due to bone flap autolysis. Furthermore, a rigid CP fixation seems to play a crucial role in reducing complication rates.

颅骨成形术 (CP) 是神经外科手术（减压）颅骨切除术后患者的标准手术。然而，CP 手术并不标准化，以不同的方式进行，并且并发症发生率相当高。在此，我们报告使用不同 CP 材料的经验，并分析长期并发症和种植体存活率。我们回顾性研究了 2004 年至 2014 年间在我们机构接受 CP 手术的患者。进行二元 Logistic 回归分析，以确定发生并发症的危险因素。 Kaplan-Meier 分析用于估计种植体存活率。共有 392 名患者（182 名女性，210 名男性），平均年龄 48 岁。这些患者总共接受了 508 例 CP 手术。原发性 CP 的总体并发症率为 33.2%，由于骨吸收/松动 (14.6%) 和移植物感染 (7.9%)，平均种植体存活率为 120 ± 5 个月。二元 Logistic 回归分析显示，年轻 (< 30 岁) ( p = 0.026，OR 3.150)、多重耐药细菌的存在 ( p = 0.045，OR 2.273) 和脑脊液 (CSF) 分流 ( p = 0.001) ，OR 3.137）是术后并发症的危险因素。使用微型钛板进行 CP 固定可降低并发症发生率和骨瓣骨质溶解，并延长种植体存活率。本研究强调了 CP 手术的风险状况。年轻（< 30 岁）和分流依赖性脑积水与术后并发症相关，尤其是由于骨瓣自溶引起的并发症。此外，刚性的 CP 固定似乎在降低并发症发生率方面发挥着至关重要的作用。