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Comparison of Differential-pressure and Flow-regulated Shunt Valves in Adult Communicating Hydrocephalus

固定壓力系統引流管及流速自動調節引流管在成人交通性水腦症的比較

摘要


Objective: The aim of the present study was to clarify whether flow-regulating shunt valves (Orbis Sigma Valve [OSV]) are advantageous in adult communicating hydrocephalus with regarding to shunt complication and surgical revision rate in comparison with standard differential-pressure valves (DPV). Methods: During a three-year period, 84 DPV and 62 OSV were implanted by two neurosurgeons for adult patients with communicating hydrocephalus. Patients medical charts were analyzed retrospectively for demographic data, diagnosis at shunt implantation, valve type, incidence of shunt complications and surgical revision rate. Results: The causes of communicating hydrocephalus of adults between two groups showed no differences; the leading three were cerebrovascular accident (CVA), traumatic brain injury (TBI) and idiopathic normal pressure hydrocephalus (NPH). The incidence of subdural collections was lower in the OSV group (11.9%, DPV vs 3.2%, OSV, P<0.05). However, the postoperative complication rate and surgical shunt revision rate did not have statistically significant difference between two groups in our study. Conclusions: In our retrospective study, the OSV shunt had the advantage of reducing incidence of non-traumatic subdural collections in the treatment of communicating hydrocephalus of adults.

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並列摘要


Objective: The aim of the present study was to clarify whether flow-regulating shunt valves (Orbis Sigma Valve [OSV]) are advantageous in adult communicating hydrocephalus with regarding to shunt complication and surgical revision rate in comparison with standard differential-pressure valves (DPV). Methods: During a three-year period, 84 DPV and 62 OSV were implanted by two neurosurgeons for adult patients with communicating hydrocephalus. Patients medical charts were analyzed retrospectively for demographic data, diagnosis at shunt implantation, valve type, incidence of shunt complications and surgical revision rate. Results: The causes of communicating hydrocephalus of adults between two groups showed no differences; the leading three were cerebrovascular accident (CVA), traumatic brain injury (TBI) and idiopathic normal pressure hydrocephalus (NPH). The incidence of subdural collections was lower in the OSV group (11.9%, DPV vs 3.2%, OSV, P<0.05). However, the postoperative complication rate and surgical shunt revision rate did not have statistically significant difference between two groups in our study. Conclusions: In our retrospective study, the OSV shunt had the advantage of reducing incidence of non-traumatic subdural collections in the treatment of communicating hydrocephalus of adults.

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