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Updated: Jul 18, 2026
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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Adjustable vs set-pressure valves decrease the risk of proximal shunt obstruction in the treatment of pediatric
Matthew J McGirt1, Donald W Buck, Daniel Sciubba
1Division of Pediatric Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 North Wolfe Street, Meyer 8-161, Baltimore, MD 21287, USA. mmcgirt1@jhmi.edu
Summary
Programmable shunt valves, used in pediatric hydrocephalus treatment, showed a lower risk of revision and proximal obstruction compared to set-pressure valves. Further studies are recommended to confirm these findings for shunt outcomes.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Biomedical Engineering
Background:
- Programmable shunt valves are increasingly used for pediatric hydrocephalus.
- Their impact on shunt outcomes compared to set-pressure valves is not well-established.
Purpose of the Study:
- To compare the shunt outcomes of programmable valves versus set-pressure valves in pediatric hydrocephalus patients.
Main Methods:
- Retrospective review of clinical and radiological records for pediatric patients undergoing shunt surgery (VP, VPl, VA) from 2001-2004.
- Kaplan-Meier plots and log-rank analysis were used to assess the association between valve type and shunt revision.
Main Results:
- A total of 279 shunt surgeries were analyzed; 27% used programmable valves and 73% used set-pressure valves.
- Programmable valves were associated with a significantly reduced risk of overall shunt revision (RR 0.61, p=0.016) and proximal obstruction (RR 0.39, p=0.006).
- No significant differences were observed in distal obstruction, infection, valve obstruction, or shunt disconnection rates.
Conclusions:
- Programmable valves demonstrated a decreased risk of proximal shunt obstruction and overall shunt revision in this patient cohort.
- These findings suggest programmable valves may be beneficial for patients prone to proximal shunt failure.
- A prospective, controlled study is needed to further evaluate the efficacy of adjustable versus set-pressure valve systems.
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