Dysfunction of a Ventriculoperitoneal Shunt After Posterior Spinal Fusion in Children with Cerebral Palsy by Kareem Abu-Sneineh, Glenn E. Lipton, Peter.

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Presentation transcript:

Dysfunction of a Ventriculoperitoneal Shunt After Posterior Spinal Fusion in Children with Cerebral Palsy by Kareem Abu-Sneineh, Glenn E. Lipton, Peter G. Gabos, and Freeman Miller J Bone Joint Surg Am Volume 85(6): June 1, 2003 ©2003 by The Journal of Bone and Joint Surgery, Inc.

Figs. 1-A through 1-F Case 1. Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-B Anteroposterior radiograph of the spine made immediately after posterior spinal fusion with unit rod instrumentation and sublaminar wiring. Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-C Routine radiograph of the chest made two days after surgery reveals a fracture of the ventriculoperitoneal shunt tubing in the cervical region (arrow). Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-D A computed tomographic scan of the head on the third postoperative day did not reveal appreciable ventricular dilation; however, no baseline scan was available for comparison. Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-E A repeat computed tomographic scan of the head made approximately four weeks after the surgery shows dilated ventricles. Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

A follow-up computed tomographic scan of the head made two weeks after shunt revision demonstrates resolution of the hydrocephalus. Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A through 2-D Case 2. Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

Close-up view of the spinal radiograph shown in Figure 2-A demonstrates the shunt fracture in the cervical region (arrow). Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior radiograph of the spine made immediately after posterior spinal fusion with unit rod instrumentation and sublaminar wiring. Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior radiograph of the spine made four weeks after surgery shows the ends of the fractured shunt to be separated by 15 mm (arrow). Kareem Abu-Sneineh et al. J Bone Joint Surg Am 2003;85: ©2003 by The Journal of Bone and Joint Surgery, Inc.