Fluoroscopic-Guided Paramedian Approach for Lumbar Catheter Placement in Cerebrospinal Fluid Shunting: Assessment of Safety and Accuracy

Operative Neurosurgery
Adam TuckerToshihiko Kuroiwa

Abstract

Spinal catheter insertion in lumboperitoneal (LP) shunt surgery for idiopathic normal pressure hydrocephalus (iNPH) is frequently associated with technical difficulties especially in patients with obesity and elderly patients with vertebral deformities. To elucidate the accuracy and safety of image-guided spinal catheter placement using a paramedian approach (PMA). We retrospectively analyzed 39 consecutive iNPH patients treated by LP shunting with spinal catheter insertion via the PMA. The success rate of catheter placement and the number of changes in puncture location were evaluated. Accuracy of catheter insertion was assessed by measuring both vertical and horizontal deviations in the point of catheter dural penetration from the center of the interlaminar space. The success rate of catheter placement was 100% (39/39). The difficulty rate for catheter insertion, measured by the number of changes in puncture location, was 2.6% (1/39). No bloody punctures or surgical infections were observed. Accuracy of catheter insertion, measured as the degree of deviation, was 0.5 ± 1.9 mm horizontally and 0.0 ± 2.4 mm vertically. The rates of minor complications, including caudal catheter insertion, transient low-pressure headache, and ro...Continue Reading

References

Sep 6, 2006·Regional Anesthesia and Pain Medicine·Takumi NagaroSyungo Abe
Nov 29, 2007·Anesthesia and Analgesia·Anna RabinowitzOlivier Fourcade
Nov 3, 2010·Cerebrospinal Fluid Research·Masaaki HashimotoUNKNOWN Study of INPH on neurological improvement (SINPHONI)
Oct 1, 2011·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Caspar Edward William AylottCameron Walker
Apr 3, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Permsak PaholpakYuichi Kasai
Dec 3, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Kerstin AndrénPer Hellström
Feb 13, 2016·Journal of Neurosurgery·Masakazu MiyajimaUNKNOWN , on behalf of the SINPHONI-2 Investigators
Feb 6, 2017·Journal of Neurosurgery. Spine·Shenandoah RobinsonHoracio Padua

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Methods Mentioned

BETA
PMA

Software Mentioned

JMP

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