Lumboperitoneal Shunt Transection during Minimally Invasive Lumbar Spine Posterior Instrumentation: A Case Report and Literature Review
Minimally invasive surgery (MIS) has rapidly gained popularity over the past decade; however, MIS pedicle screw placement can pose risks to existing devices, such as lumboperitoneal (LP) shunts, if the surgeon is unaware of their presence. Damage to the LP shunt can lead to serious complications, hi...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-04-01
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| Series: | Formosan Journal of Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/fjmd.FJMD-D-24-00014 |
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| Summary: | Minimally invasive surgery (MIS) has rapidly gained popularity over the past decade; however, MIS pedicle screw placement can pose risks to existing devices, such as lumboperitoneal (LP) shunts, if the surgeon is unaware of their presence. Damage to the LP shunt can lead to serious complications, highlighting the importance of spine, abdominal, and pelvic surgeons being mindful of shunt-related issues. A 70-year-old female with an LP shunt for normal-pressure hydrocephalus fell and sustained an L3 burst fracture with radiculopathy. During percutaneous pedicle screw placement, patient’s LP shunt was transected. A neurosurgeon was consulted but was unavailable to perform the LP shunt revision at that time. Owing to limited materials and surgical experience, the LP shunt was not revised or reconnected during the initial surgery. Two months later, the patient presented with a mild headache and unsteady gait. A computed tomography scan revealed enlarged ventricles. The patient subsequently underwent successful revision of the LP shunt placement and achieved full recovery. This case report emphasizes the prevention of complications arising from MIS screw placement that interfered with a previously placed LP shunt, particularly near the entry point and along the path of the pedicle screw. MIS pedicle screw placement has become a popular surgical procedure. However, without direct visualization through open exposure, careful preoperative planning, from determining the entry point to routing the screw, should be performed cautiously to prevent injury to neighboring structures and existing devices, such as LP shunts. Otherwise, additional surgery may be necessary to repair the LP shunt and restore its function. |
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| ISSN: | 2210-7940 2210-7959 |