Surgical correction of sagittal craniosynostosis: complications of the pi procedure.

We have completed a retrospective analysis of our experience with the pi procedure to determine the complications of the technique. Forty-five children underwent correction of scaphocephaly during the last 4 years. The average patient age was 9.2 months. The modified prone position with beanbag head support was used in 40 of 45 patients. Accompanied by barrel-stave and radial osteotomies, the reverse procedure was performed in 18 patients and frontal pulling in 27 patients. The average anteroposterior skull reduction was 1.44 cm, and mean blood loss was 96 ml, 11 ml/kg, replaced in 36 patients. Complications included three dural injuries, and air embolism was not detected by Doppler or end-tidal monitoring. A single child had a postoperative seizure. We conclude that complications of the pi procedure are limited and compare favorably with other repair techniques. We consider the pi procedure the technique of choice for correction of sagittal craniosynostosis in patients older than 3 months.