‘Super elastic’ springs used in world-first surgery at Great Ormond Street Hospital

The newly developed springs are made of a special metal called nitinol, an alloy nickel and titanium, of which allows a safer, more flexible and highly personalised treatment for children with complex forms of the condition.

20 years ago, stainless steel springs were developed at GOSH with partners at University College London (UCL) to treat sagittal craniosynostosis, which is a rare condition where the skull fuses before birth and the skull becomes long from front to back and narrow from side to side. Patients undergo surgery which involves removing a tiny piece of skull bone, making cuts either side of the fused sagittal suture and inserting the springs that gradually widen the gap, which encourages new bone to grow in between the two cut surfaces. It also enlarges the space within the skull to allow the brain to grow and develop.

Although these stainless-steel springs have been successfully used for the last 20 years, there are some patients whereby their case is so severe that stainless-steel springs will not change the shape to the optimal degree as clinicians do not have as much control over the force, they use to change the skull shape. This can be where further surgery is required.

Unlike traditional stainless-steel devices, nitinol springs have super elastic properties, allowing them to adapt more naturally to a child’s growing skull. Each spring is custom designed for the individual child using advanced imaging and computer modelling. 

The springs were developed through a longstanding collaboration between surgeons at GOSH, led by Professor Owase Jeelani, Consultant Neurosurgeon and biomedical engineers at UCL, led by Professor Silvia Schievano, Professor of Biomedical Engineering and Dr Alessandro Borghi, now at Durham University. 

Using CT scans, the team create a detailed digital model of the child’s skull which predicts how it will respond to surgery and then designs bespoke springs to deliver the right level of force in exactly the right place.

The modelling process takes around one day and allows surgeons to plan the operation with exceptional precision. The surgery itself takes just under an hour, cutting the original surgery time in half. The springs remain in place for several weeks to months, gradually reshaping the skull before being removed.

Rory was born 12 days early after being breach for 10 weeks, in April 2025. Before being discharged from hospital, Mum, Jo and Dad, Harry were asked if they had any concern and they mentioned Rory’s head being longer.

Due to Rory’s head being elongated, it was suspected by that he may have sagittal craniosynostosis. After Jo and Harry researched possible treatment options, Rory was transferred to GOSH, where his diagnosis was confirmed.

As Rory’s sagittal craniosynostosis was severe, the surgical team felt Rory would have better outcomes if he was able to have nitinol springs instead of the traditional steel-springs.

Professor Jeelani, who would lead the surgery, spoke to Jo and Dad, Harry, about what the surgery would involve and how Rory would be the first patient in the world to have the nitinol springs used in his skull. 

Jo said: “Throughout the process, every element was explained so well. We knew what was going to happen and how, we received amazing support from each member of the team.”

Rory had his surgery at GOSH in September 2025 It took Professor Jeelani and his team around 45 minutes to complete the insertion of the springs to the skull. 

The family only had to stay overnight after surgery for monitoring before they could go home while the springs worked to change the shape of Rory’s skull. Nine weeks later, Rory was back to have the springs removed after his skull had reached the desired outcome.

Now Rory is back home in Peak District, getting to play and having fun with his older brother, Oscar, 3 and their family dog, Ada.

Jo said: “Rory is so happy, cheeky and full of energy. You wouldn’t know what he’s been through, he’s just like every little boy and hitting milestones and he will have a great story to tell when he’s older.

“We cannot thank the team enough for the care, compassion and reassurance. Not to mention their dedication to medical science to support and help children thrive.”  

Consultant neurosurgeon, Professor Owase Jeelani: “Traditional stainless-steel springs are very robust, but they don’t always allow us to finetune the force on the skull. These new nitinol springs give us much greater flexibility and, in some cases, can prevent the need for further surgery.

“This first surgery is important progress for children with craniosynostosis and so far, we have seen fantastic outcomes.”

Historically, craniosynostosis surgery involved longer, more invasive operations with high blood transfusion rates. Spring assisted techniques have already made surgery safer and shorter, and the personalised nitinol springs build on that progress.

Professor Silvia Schievano said: “This has been many years in the making, with thousands of hours of necessary research undertaken. 

“It is a very proud moment to see this technology used in a child with such a positive result. It uplifts the importance of engineering research and clinical care coming together to develop new technologies for improved healthcare.”

Dr Alessandro Borghi said: “It is extremely rewarding to see our research efforts translate into a tangible improvement in the life of a baby. This achievement demonstrates the real-world impact that can be achieved through close collaboration between engineering and clinical research. 

“We hope this success serves to highlight the importance of investing in and promoting medical technology, showcasing its potential to drive meaningful innovations that improve patient care and clinical outcomes.”

As nitinol springs are new, their use currently requires individual approval from the Medicines and Healthcare products Regulatory Agency (MHRA) for each patient. The team are hoping to see how they can extend access to this technology to more patients. 

The research for nitinol springs is underpinned by funding from Great Ormond Street Hospital Charity and National Institute for Health and Care Research GOSH Biomedical Research Centre (NIHR GOSH BRC).

Aoife Regan, GOSH Charity’s Director of Impact and Charitable Programmes, said: “We are so proud to have provided over £1million of funding for this work via the Face Value project, which aims to improve treatment for children with complex forms of craniosynostosis. 

“GOSH Charity is the largest charitable funder of medical research dedicated to paediatrics in the UK and, as part of our commitment to give seriously ill children the best chance, and best childhood possible, we are currently implementing our £70m research strategy to transform the lives of children through research-led care.”

Professor Marian Knight, Scientific Director for NIHR Infrastructure, said: "By funding innovative research into treatments such as these ‘memory-metal’ springs, the NIHR enables researchers to help children like Rory receive safer, more precise, and highly personalised care. 

“For over 20 years, NIHR has provided the vital foundations, funding, and collaborative environments necessary to turn innovative concepts into life-changing clinical realities. This exciting collaboration, including research expertise in surgery, engineering”