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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

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Do patients with open spina bifida always need a shunt for lifetime? A long-term follow-up

Meeting Abstract

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  • Dieter Class - Klinik für Neurochirurgie der Universität Magdeburg, Deutschland
  • Steffen Pauli - Klinik für Neurochirurgie der Universität Magdeburg, Deutschland
  • Roberto Michilli - Klinik für Neurochirurgie des Klinikums Stuttgart, Deutschland
  • Nicolai J. Hopf - Klinik für Neurochirurgie des Klinikums Stuttgart, Deutschland
  • Raimund Firsching - Klinik für Neurochirurgie der Universität Magdeburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1678

doi: 10.3205/10dgnc150, urn:nbn:de:0183-10dgnc1508

Published: September 16, 2010

© 2010 Class 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: More than 80% of children with open spina bifida are expected to develop hydrocephalus eventually requiring a shunt system. To our knowledge there are no long-term follow-up studies especially on shunt function in older patients with spina bifida.

Methods: We reviewed 69 patients previously operated on for open spina bifida. From this group 61 patients received a shunt system. We investigated the function of the shunt taking into account neurological, ophthalmological and radiological findings. Follow-up in months ranged from 2 to 439 with a median of 115 months.

Results: 88% of the patients required a shunt. Mostly ventriculo-peritoneal shunts were placed. 5 patients (age 24–39) were clinically stable with radiologically doubtful position of the distal catheter or after a shunt removal for other reasons before. With 3 patients shunt revision was necessary due to clinical symptoms of intracranial hypertension or hypotension confirmed by radiological studies showing disconnection in 2 and valve failure in 1 patient.

Conclusions: Despite shunt dependency in a high percentage (88%) in childhood later on in life a variety of clinical and radiological findings are to be expected requiring individual evaluation. In our group of 61 patients 5 patients (8%) showed longstanding clinical stability with a disconnected or displaced or removed shunt. A close clinical follow up including EEG recording and fundoscopy in this group appears advisable. Signs of shunt malfunction were noted in 2 patients after a long interval of 22 and 30 years after first shunt placement.