ISSN: 2578-482X
Authors: Faraji Rad M* and Mohazzab Torabi S
Background: Lumboperitoneal (LP) shunt placement is a key neurosurgical procedure for managing conditions such as idiopathic intracranial hypertension (IIH) and normal pressure hydrocephalus (NPH). Although the procedure has been performed for decades, there remains a need for a comprehensive analysis of its efficacy, safety, and long-term outcomes, as well as a reflection on clinical experience accumulated over time. Objective: This systematic review aims to evaluate the clinical outcomes, indications, complications, and surgical techniques associated with lumboperitoneal shunt placement, while integrating over 30 years of personal experience performing this procedure. A systematic review was conducted following the PRISMA guidelines. We searched PubMed, Scopus, Web of Science, Embase, and Cochrane Library for studies published up to (date), without limitations on study type or language. Studies were included if they reported on the clinical use of LP shunts for treating IIH, NPH, or other conditions associated with CSF circulation disorders. In parallel, we reflect on a personal 30-year surgical experience with LP shunting, including patient outcomes, surgical techniques, and complications encountered. Results: The systematic review included (number) studies encompassing (number) patients. Results showed that LP shunts are effective in reducing symptoms of IIH and NPH, with clinical improvement rates ranging from (range) %. However, complication rates, including shunt malfunction, over drainage, and infection, remain a concern. Personal experience over 30 years corroborates these findings, with a focus on technical refinements and optimal patient selection to reduce complications and improve long-term outcomes. Conclusion: LP shunt placement remains an effective therapeutic option for certain neurological conditions, though it is associated with a significant risk of complications. Through both the systematic review and personal surgical experience, we emphasize the importance of careful patient selection, refinement in surgical technique, and proactive management of complications to optimize patient outcomes.
Keywords: Lumboperitoneal Shunt; Cerebrospinal Fluid Diversion; Idiopathic Intracranial Hypertension; Normal Pressure Hydrocephalus; Shunt Complications
