gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Inclusion of gravity assisted units in first time pediatric hydrocephalus shunts – Influence on shunt outcome

Meeting Abstract

  • Marcel Kullmann - Sekion Pediatrische Neurochirurgie, Klinik für Neurochirurgie, Eberhard Karls Universitätsklinikum, Tübingen, Deutschland
  • Thayane Fritz - Sekion Pediatrische Neurochirurgie, Klinik für Neurochirurgie, Eberhard Karls Universitätsklinikum, Tübingen, Deutschland
  • Artemisia Dimostheni - Sekion Pediatrische Neurochirurgie, Klinik für Neurochirurgie, Eberhard Karls Universitätsklinikum, Tübingen, Deutschland
  • Karin Haas-Lude - Kinderkrankenhaus, Universitätsklinikum Tübingen
  • Martin U. Schuhmann - Sekion Pediatrische Neurochirurgie, Klinik für Neurochirurgie, Eberhard Karls Universitätsklinikum, Tübingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocDI.06.03

doi: 10.3205/14dgnc144, urn:nbn:de:0183-14dgnc1444

Published: May 13, 2014

© 2014 Kullmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: The addition of a gravity-assisted unit (GAU) at the time of first shunt implantation in pediatric hydrocephalus is thought to prevent overdrainage right at the very beginning. However, the influence of GAUs on the shunt revision rate is unclear. We compared shunt survival data of two cohorts of children with first-time implanted adjustable shunts with and without GAU.

Method: Between 1/2006 and 08/2010 82 children underwent first-time shunt implantation. Starting in 2008 GAUs were added in increasing frequency. 31 children received Codman Medos programmable-valve (without GAU group A) and 33 Miethke proGAV valve (including GAU, group B). A retrospective data analysis was performed.

Results: Mean follow-up for group A was 40.7 months, for Group B 30.3 months. In Group A 18/31 (58%) underwent further shunt related surgery, in Group B 15/33 (45%). Valve related reasons for revision (overdrainage-underdrainage-valve occlusion) were found in 8-1-4 patients, respectively in Group A (72%) and 0-2-2 respectively in Group B (27%). Non-valve-dependent reasons for revision (catheter related-infection-wound healing problems) were found in 5-0-1 patients in Group A and 6-1-5 patients in Group B, respectively.

Conclusions: The addition of a GAU to an adjustable valve system at first-time shunt implantation does not seem increase the rate of shunt surgery during follow-up. In this study however, it significantly decreased the chance of overdrainage or other valve-related interventions.