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

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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The Frankfurt Horizontal Plane (FHP) as a reference for the implantation of gravitational units: A series of 376 patients

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  • Florian Baptist Freimann - Klinik für Neurochirurgie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen; Klinik für Neurochirurgie, Charité – Universitätsmedizin Berlin
  • Stefan Wolf - Klinik für Neurochirurgie, Charité – Universitätsmedizin Berlin
  • Veit Rohde - Klinik für Neurochirurgie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen
  • Christian Sprung - Klinik für Neurochirurgie, Charité – Universitätsmedizin Berlin

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.06.01

doi: 10.3205/14dgnc142, urn:nbn:de:0183-14dgnc1426

Published: May 13, 2014

© 2014 Freimann 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 in-line combination of adjustable differential pressure valves with fixed gravitational units as the proGAV seems to be beneficial for the treatment of overdrainage-related complications associated with ventriculoperitoneal shunting. The implantation angle especially of the gravitational unit is decisive here for the opening pressure of those valve combinations. In this study, we aimed to provide data on the relevance of the spatial relationship of the gravitational unit to the Frankfurt Horizontal Plane (FHP) for the incidence of primary ovedrainage and underdainage of CSF.

Method: We analyzed retrospectively the postoperative course of 376 consecutive patients, who received a ventriculoperitoneal shunt with proGAV valve between 2004 and 2011 for the treatment of different hydrocephalus entities. The implantation angle of the gravitational unit in relation to the FHP and the patients' general parameters (age, body height, body weight, gender, hydrocephalus entity) were correlated with the incidence of primary CSF overdrainage and underdainage by applying an univariate analysis.

Results: Primary overdrainage was found in 41 (10.9%) patients. Primary underdainage was found in 113 (30,1%) patients. A deviation of the implantation angle from the vertical line of the FHP was found in 360 (95,7%) cases (reclination 185 cases with mean 9.7° (±7.7) deviation, inclination in 175 cases with mean 10.3° (±8) deviation). The deviation from the vertical line to the FHP was in 95% of the cases less than 25°. No significant correlation between the implantation angle in relation to the FHP and the incidence of overdrainage or underdainage of CSF was found in our study population.

Conclusions: The deviation of the implantation angle of the gravitational unit within a range of 25° to the vertical line of the FHP did not predispose for a primary overdrainage or underdainage of CSF in our study population. The FHP appears recommendable as a reference for the implantation of gravitational units.