To investigate the clinical value of preoperative Mark combined with intraoperative ultrasound multimodal assisted localization in ventriculo-peritoneal shunt for the treatment of hydrocephalus and skull defects.

A retrospective analysis was conducted on the clinical data of 46 patients with hydrocephalus and skull defects who underwent ventriculo-peritoneal shunt surgery in the Neurosurgery Department of Suzhou Xiangcheng People's Hospital from January 2019 to January 2024. Among them, 26 patients underwent surgery using preoperative Mark positioning combined with intraoperative ultrasound multimodal technology (modified surgery group), and 20 patients underwent surgery using traditional methods (traditional surgery group). The accuracy of puncture catheterization, number of punctures, surgical time, and perioperative complications were compared between two groups of patients. Follow up for 3-24 months after surgery was conducted to evaluate the functional recovery of two groups of patients using the modified Rankin scale (mRS).

The position of the ventricular catheter position in the modified surgery group was significantly better than that in the traditional surgery group, and the number of punctures was less than that in the traditional surgery group, with statistically significant differences (P<0.05). There was no statistically significant difference in the surgical time and incidence of perioperative complications between the two groups of patients (P>0.05). During the follow-up period of 3-24 months, there was a statistically significant difference in the distribution of mRS scores between the two groups of patients (P<0.05), but there was no statistically significant difference in the total effective rate (P>0.05).

In patients with hydrocephalus complicated by skull defects, the use of preoperative Mark localization and intraoperative ultrasound guidance during ventriculo-peritoneal shunt surgery is more accurate with low cost.