Tubbs R Shane, Goodrich Dylan, Tubbs Isaiah, Loukas Marios, Cohen-Gadol Aaron A
Pediatric Neurosurgery, Children's Hospital of Alabama, Birmingham, AL, USA,
Childs Nerv Syst. 2014 Dec;30(12):2115-7. doi: 10.1007/s00381-014-2521-5. Epub 2014 Aug 17.
Few innovations in the method of tunneling shunt tubing for cerebrospinal fluid (CSF) shunt diversion have been made since this treatment of hydrocephalus was first developed. Therefore, this feasibility study was performed with the hope of identifying an improved technique that could potentially carry fewer complications.
On 10 cadaver sides and when placed in the supine position, small skin incisions were made at the clavicle and ipsilateral subcostal region, and magnets were used to pass standard shunt tubing between the two incisions.
Nickel-plated magnets were less effective in pulling the shunt tubing below the skin compared with ceramic magnets. Of these, magnets with pull strengths of 150-200 lbs were the most effective in dragging the subcutaneous tubing between the two incisions. No obvious damage to the skin from the overlying magnet was seen in any specimen.
Few options exist for tunneling distal shunt tubing for CSF shunt procedures. Future patient studies are needed to determine if the technique described herein is superior to current methods, particularly when examining patient groups that are at a greater risk for injury during tunneling shunt catheters.
自从首次开发脑积水的这种治疗方法以来，用于脑脊液（CSF）分流引流的隧道式分流管方法几乎没有创新。因此，进行这项可行性研究，希望找到一种可能具有更少并发症的改进技术。
在10个尸体侧位且处于仰卧位时，在锁骨和同侧肋下区域做小皮肤切口，并用磁铁在两个切口之间穿过标准分流管。
与陶瓷磁铁相比，镀镍磁铁在将分流管拉至皮肤下方方面效果较差。其中，拉力强度为150 - 200磅的磁铁在拖动两个切口之间的皮下管道方面最有效。在任何标本中均未观察到覆盖磁铁对皮肤造成明显损伤。
在脑脊液分流手术中，用于隧道式远端分流管的方法选择很少。未来需要进行患者研究，以确定本文所述技术是否优于当前方法，特别是在检查分流导管隧道置入过程中受伤风险更高的患者群体时。
