title: Ventriculoperitoneal Shunt Fracture Following Application of Halo-Gravity Traction: A Case Report.
abstract: 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.
  
  
  METHODS
  Level IV.
authors.affiliation: Shriners Hospital for Children, Portland, OR.
authors.forename: William G
authors.initials: WG
authors.lastname: Blakeney
authors.forename: Charles
authors.initials: C
authors.lastname: D'Amato
mesh_terms: D000015:Abnormalities, Multiple / Q000628:therapy*; D002574:Cervical Vertebrae; D002648:Child; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011475:Prosthesis Failure / Q000209:etiology*; D012086:Reoperation / Q000379:methods; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D014057:Tomography, X-Ray Computed; D014143:Traction / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*