Treatment of hydrocephalus determined by the European Orbis Sigma Valve II survey: a multicenter prospective 5-year shunt survival study in children and adults in whom a flow-regulating shunt was used

Hanlo, Patrick W.; Cinalli, Giuseppe; Vandertop, W. Peter; Faber, J. A. J.; Bøgeskov, Lars; Børgesen, S. E.; Boschert, Jürgen; Chumas, Paul; Eder, Hans G.; Pople, Ian; Serlo, Willy; Vitzthum, Eckehard

doi:10.3171/jns.2003.99.1.0052

Cited by 106 publications

(59 citation statements)

References 42 publications

(34 reference statements)

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“…However, the valve obstruction rate was 8.4%, probably due to the device's design. 4 Encouraging results have been reported with gravitational valves in childhood hydrocephalus: in the study of Eymann and coworkers, 3 the rate of overdrainage in 55 children who underwent shunt placement was only 3.6% and the valve obstruction rate was 0%. Cedzich and Wiessner 2 did not observe any overdrainage complications in a series of 32 children who received shunts.…”

Section: Discussionmentioning

confidence: 95%

First experiences with an adjustable gravitational valve in childhood hydrocephalus

Rohde

Haberl

Ludwig

et al. 2009

PED

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Object The goal of this report was to describe the authors' initial experiences with an adjustable gravity-assisted valve (GAV) called the ProGAV in treating childhood hydrocephalus. Methods The ProGAV was implanted in 53 children (29 boys and 24 girls, median age 7.3 years) with hydrocephalus of various origins. The ProGAV consists of a differential-pressure unit with adjustable opening pressures and a gravitational unit with a fixed opening pressure. Results The mean follow-up period was 15.2 months (range 6–44 months). The authors did not observe any valve-related complications. Four infections (7.5%) occurred, warranting the removal of the shunt. In 19 children, the opening pressure was changed at least once during the follow-up period, for underdrainage in 10, overdrainage in 8, and shunt weaning in 1, with substantial clinical improvement in 18 children. Overall, good clinical results were obtained in 47 (88.7%) of the 53 valve placements. Conclusions With an overall success rate of 88.7%, the first experiences with the ProGAV in childhood hydrocephalus are promising and justify its further use in the pediatric population.

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Section: Discussionmentioning

confidence: 95%

First experiences with an adjustable gravitational valve in childhood hydrocephalus

Rohde

Haberl

Ludwig

et al. 2009

PED

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“…Twenty-two articles were included in the final evidentiary table. Reasons for exclusion of fulltext articles included the absence of a valid comparison group (n = 14), [1][2][3][7][8][9][10]12,13,20,25,26,28,35 the absence of a valid outcome variable (n = 4), 14,18,22,32 invalid study design (n = 2), 30,31 and redundant patient population (n = 1) (Fig. 1).…”

Section: Search Resultsmentioning

confidence: 99%

“…The majority of excluded papers did not include a comparison group or control group. [1][2][3][7][8][9][10]12,13,20,25,26,28,35 Other reasons for exclusion included invalid study design (questionnaire survey), 30,31 redundant patient population 5 (only the paper with the longest reported follow-up was included), and absence of a valid outcome variable (change in ventricle size, development of spinal canal stenosis, historical description, and frequency of hospital visits). 14,18,22,32 Conclusions recommendation: There is insufficient evidence to demonstrate an advantage of one shunt hardware design over another for the treatment of pediatric hydrocephalus.…”

Section: Excluded Studiesmentioning

confidence: 99%

Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 5: Effect of valve type on cerebrospinal fluid shunt efficacy

Baird

Mazzola

Auguste

et al. 2014

PED

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Object The objective of this systematic review was to examine the existing literature to compare differing shunt components used to treat hydrocephalus in children, find whether there is a superior shunt design for the treatment of pediatric hydrocephalus, and make evidence-based recommendations for the selection of shunt implants when placing shunts. Methods Both the US National Library of Medicine PubMed/MEDLINE database and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words chosen to identify publications comparing the use of shunt implant components. Abstracts of these publications were reviewed, after which studies meeting the inclusion criteria were selected. An evidentiary table was compiled summarizing the selected articles and quality of evidence. These data were then analyzed by the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force to consider evidence-based treatment recommendations. Results Two hundred sixty-nine articles were identified using the search parameters, and 43 articles were recalled for full-text review. Of these, 22 papers met the study criteria for a comparison of shunt components and were included in the evidentiary table. The included studies consisted of 1 Class I study, 11 Class II studies, and 10 Class III studies. The remaining 21 articles were excluded. Conclusions An analysis of the evidence did not demonstrate a clear advantage for any specific shunt component, mechanism, or valve design over another. Recommendation: There is insufficient evidence to demonstrate an advantage for one shunt hardware design over another in the treatment of pediatric hydrocephalus. Current designs described in the evidentiary tables are all treatment options. Strength of Recommendation: Level I, high degree of clinical certainty. Recommendation: There is insufficient evidence to recommend the use of a programmable valve versus a nonprogrammable valve. Programmable and nonprogrammable valves are both options for the treatment of pediatric hydrocephalus. Strength of Recommendation: Level II, moderate degree of clinical certainty.

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“…Posterior decompression fusion could then be performed for cases with reducible BI, whereas combined odontoid resection followed by posterior fusion was proposed for irreducible BI. However, we suggest that this may not necessarily to be the first choice of operative procedure, since VP shunting often causes obstruction: in a multicenter study, 39% of patients experienced complications in 5 years after this operation [17]. Combined odontoid resection is clearly beneficial for BI because it directly removes pressure on the brain stem.…”

Section: Discussionmentioning

confidence: 99%

Factors related to surgical outcome after posterior decompression and fusion for craniocervical junction lesions associated with osteogenesis imperfecta

et al. 2011

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Treatment for craniocervical junction lesions associated with osteogenesis imperfecta (OI) has been described, but there are divergent views on operative procedures and preoperative and postoperative therapies due to the small number of cases. It has been suggested that a major procedure such as combined anterior and posterior surgery with concomitant ventriculoperitoneal (VP) shunting is required for OI associated with basilar impression (BI). However, here we report a case with a good outcome after posterior decompression fusion only. The patient was a 29-year-old woman with OI (Sillence type-IA) who had neurological symptoms of vertigo, nausea, and shaking during walking. Diagnostic imaging revealed hydrocephalus, severe BI, and Chiari type-II malformation. Preoperative Halo traction led to improvement in symptoms, and posterior decompression fusion from the occipital bone to C6 was subsequently performed. Lateral mass screws and Nesplon cables as sublaminar wiring for reinforcement for fusion were used in the operation. The patient wore a Halo vest for 4 weeks postoperatively. She experienced no symptoms postoperatively. Bone fusion and improved hydrocephalus were clear on images at 3 years after surgery, and the postoperative course has been good. In craniocervical junction lesions associated with OI, instability with compression of the nerve and bone fragility in multiple sites can become problematic. Anterior odontoid resection and posterior fusion are required for OI with BI to give ideal decompression on images. However, the results of this case suggest that a good postoperative outcome can be achieved by performing not the combination of anterior odontoid resection and VP shunting, but only with posterior decompression fusion, especially for OI cases of Sillence type-I.

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Treatment of hydrocephalus determined by the European Orbis Sigma Valve II survey: a multicenter prospective 5-year shunt survival study in children and adults in whom a flow-regulating shunt was used

Cited by 106 publications

References 42 publications

First experiences with an adjustable gravitational valve in childhood hydrocephalus

First experiences with an adjustable gravitational valve in childhood hydrocephalus

Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 5: Effect of valve type on cerebrospinal fluid shunt efficacy

Factors related to surgical outcome after posterior decompression and fusion for craniocervical junction lesions associated with osteogenesis imperfecta

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