TY - JOUR
T1 - Ventriculoperitoneal Shunt Fracture Following Application of Halo-Gravity Traction
T2 - A Case Report
AU - Blakeney, William G
AU - D'Amato, Charles
PY - 2015/9
Y1 - 2015/9
N2 - BACKGROUND: Ventriculoperitoneal (VP) shunt malfunctions are very common, and shunt fracture is one of the most common causes. Shunt fractures are often a result of calcification and tethering, which predispose the tubing to fracture when mechanical stresses are applied. This case report describes a case of shunt fracture following application of halo-gravity traction for correction of spinal deformity.METHODS: Chart and imaging data for a single case were reviewed and reported in this retrospective case study.RESULTS: A 10-year-old female, being treated for syndromic scoliosis, underwent posterior surgical release and application of halo-gravity traction. Increasing weight of traction was applied over a period of 6 weeks, for gradual deformity correction. It was noted on the 6-week cervical spine radiograph that the VP shunt had fractured at the base of the neck. The patient was taken to the operating room and intraoperative findings confirmed shunt fracture. This was repaired without complications.CONCLUSIONS: This case, to our best knowledge, is the first reported occurrence of shunt fracture following application of halo-gravity traction. It demonstrates the importance of careful monitoring of patients with VP shunts, when they are undergoing traction for correction of spinal deformity.LEVEL OF EVIDENCE: Level IV.
AB - BACKGROUND: Ventriculoperitoneal (VP) shunt malfunctions are very common, and shunt fracture is one of the most common causes. Shunt fractures are often a result of calcification and tethering, which predispose the tubing to fracture when mechanical stresses are applied. This case report describes a case of shunt fracture following application of halo-gravity traction for correction of spinal deformity.METHODS: Chart and imaging data for a single case were reviewed and reported in this retrospective case study.RESULTS: A 10-year-old female, being treated for syndromic scoliosis, underwent posterior surgical release and application of halo-gravity traction. Increasing weight of traction was applied over a period of 6 weeks, for gradual deformity correction. It was noted on the 6-week cervical spine radiograph that the VP shunt had fractured at the base of the neck. The patient was taken to the operating room and intraoperative findings confirmed shunt fracture. This was repaired without complications.CONCLUSIONS: This case, to our best knowledge, is the first reported occurrence of shunt fracture following application of halo-gravity traction. It demonstrates the importance of careful monitoring of patients with VP shunts, when they are undergoing traction for correction of spinal deformity.LEVEL OF EVIDENCE: Level IV.
KW - Abnormalities, Multiple/therapy
KW - Cervical Vertebrae
KW - Child
KW - Female
KW - Humans
KW - Hydrocephalus/surgery
KW - Postoperative Complications/diagnosis
KW - Prosthesis Failure/etiology
KW - Reoperation/methods
KW - Scoliosis/surgery
KW - Spinal Fusion/methods
KW - Tomography, X-Ray Computed
KW - Traction/adverse effects
KW - Treatment Outcome
KW - Ventriculoperitoneal Shunt/adverse effects
U2 - 10.1097/BPO.0000000000000510
DO - 10.1097/BPO.0000000000000510
M3 - Article
C2 - 25955170
VL - 35
SP - e52-4
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
SN - 0271-6798
IS - 6
ER -