Does CT wand guidance improve shunt placement in patients with hydrocephalus?

Dane Moran, Thomas A. Kosztowski, Ignacio Jusué-Torres, Dennis Orkoulas-Razis, Ayobami Ward, Kathryn Carson, Jamie Hoffberger, Benjamin D. Elder, C. Rory Goodwin, Daniele Rigamonti

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Object To evaluate the effectiveness of stereotactic navigation in enhancing the accuracy of ventricular shunt placement in patients with hydrocephalus. Methods A retrospective cohort study at a single institution by a single surgeon was performed. Consecutive patients who underwent implantation of a ventricular shunt for the management of hydrocephalus between July 2001 and December 2011 were included in the study, totaling 535 patients. Patients were classified as either having optimal or sub-optimal placement of the shunt into the ventricle. Multiple logistic regression analysis was used. Results Overall, 93.8% of patients were found to have optimal shunt placement. On multivariate analysis, navigation use was not significantly associated with improved accuracy of shunt placement (odds ratio [OR] = 0.54; 95% confidence interval [CI] = 0.19-1.54; p = 0.25). Pseudotumor cerebri diagnosis was significantly associated with increased odds of sub-optimal shunt placement (OR = 6.41; 95% CI = 1.90-21.59; p = 0.003). Conclusions CT guided navigation did not significantly improve the accuracy of ventricular shunt placement in adults with hydrocephalus for an experienced surgeon. Further studies are required to assess the utility of CT guided navigation for less experienced surgeons and patients with small or dysmorphic ventricles.

Original languageEnglish (US)
Pages (from-to)26-30
Number of pages5
JournalClinical Neurology and Neurosurgery
StatePublished - May 2015


  • Frameless stereotaxy
  • Hydrocephalus
  • Neuronavigation
  • Pseudotumor cerebri
  • Ventriculoperitoneal shunt

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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