Abstract
BACKGROUND: Reconstruction of cranial bone defects after craniotomy remains a contemporary neurosurgical challenge, necessitating an ongoing search for optimal synthetic materials that ensure effective healing, minimal postoperative complications, and satisfactory cosmetic outcomes. This issue is particularly critical in pediatric patients, in whom the dynamic nature of skull growth presents additional reconstructive complexities. Biodegradable implants with osteogenic and osteoconductive properties represent a promising solution, aiming to reduce complications commonly associated with rigid materials, such as skull deformation, and to enable gradual replacement of implants with native bone tissue. OBSERVATIONS: In this study, the authors report a series of 6 cranioplasty procedures utilizing CyberBone implants, involving 4 pediatric patients of varying ages and 2 adults. Despite the theoretical advantages of these implants, their clinical experience did not meet expectations in terms of mechanical stability, aesthetic outcomes, or evidence of osteointegration. LESSONS: Complications of varying severity, including implant deformation, resorption without adequate bone substitution, and poor cosmetic results, occurred in all patients. Based on these outcomes, the authors do not recommend CyberBone implants for routine clinical use in cranial reconstructions. Further material refinement and comprehensive safety studies are warranted before considering broader implementation in pediatric and adult populations. https://thejns.org/doi/10.3171/CASE25570.