Lumbar lordosis is a risk factor for lumbar catheter fracture of lumboperitoneal shunt

Abstract

Objective: This study aimed to investigate the causes of lumboperitoneal (LP) shunt failure and determine risk factors for lumbar catheter fracture.

Methods: We retrospectively investigated 149 patients who underwent LP shunting in our hospital between January 2012 and March 2023. Shunt reconstruction occurred in 22 patients (14.8%). Among these, cause of failure was lumbar catheter fracture in five (22.7%). Patient backgrounds, cause of LP shunt failure, surgical technique factors, and anatomical characteristics were extracted for comparative analysis and risk factors of lumbar catheter fracture were analyzed.

Results: Compared with the no reoperation group (n=127), patients in the lumbar catheter fracture tended to be younger (63 ± 20 vs. 72 ± 11 years) and favorable neurological status (modified Rankin scale score ≤2) after initial LP shunt; however the differences were not significant. Lumbar lordosis was significantly higher in the lumbar catheter fracture group (52.7° ± 14.8° vs. 37.1° ± 12.3°; P = 0.0067).

Conclusions: Excessive lumbar lordosis is a risk factor for lumbar catheter fracture in patients undergoing LP shunting. Younger age and higher level of postoperative activities of daily living might also be associated with lumbar catheter fracture.

Keywords: LP shunt; excessive lumbar lordosis; lumbar catheter fracture; shunt failure.