Lumboperitoneal shunts: are the complications acceptable?

BACKGROUND: Lumboperitoneal shunts have long been used in the treatment of benign intracranial hypertension, postoperative pseudomeningocele, CSF leak and communicating hydrocephalus. Although they can provide a rapid and effective resolution of the symptoms there are major disadvantages associated with their use.

METHOD: We retrospectively analyzed the records of 21 patients who underwent LP shunt insertion in our institution during the study period.

FINDINGS: Eighteen patients (85.7%) underwent at least one shunt revision with a total of 63 revisions. Shunt related infections were observed in 7 cases and 7 patients developed Chiari malformation, 2 (9%) of these requiring further treatment.

CONCLUSIONS: Despite the symptomatic control achieved with lumboperitoneal shunts we find the complication and revision rates unacceptably high. The technique should be re-evaluated and other treatment strategies considered.