Cord Compression Caused by a Tangled and Warped Lumbar Catheter After Lumboperitoneal Shunt Placement

Abstract

The present study reports the case of an 81-year-old woman who underwent lumboperitoneal shunt (LPS) placement for idiopathic normal-pressure hydrocephalus. After LPS placement, the patient presented with radicular pain. A computed tomography scan revealed that the intradural lumbar catheter was tangled at the T11 vertebra; therefore, we decided to remove the catheter under local anesthesia. When 1 cm of the lumbar catheter was withdrawn, the patient suddenly complained of complete loss of bilateral leg sensation and muscle strength. Emergency magnetic resonance imaging revealed that the lumbar catheter was tangled and wedged into the ventral spinal cord at T11, causing severe spinal cord compression. In the operating room under general anesthesia, the lumbar catheter was removed through a right T12 hemilaminectomy. Postoperatively, her neurological function was fully restored. Although LPS placement is frequently indicated for idiopathic normal-pressure hydrocephalus, recognition of this rare complication is important for proper LPS management.

Keywords

• Lumboperitoneal shunt
• Myelopathy
• Spinal cord compression