Creating of “fascial sheath” around subcutaneous lumboperitoneal shunt catheters largely prevents postoperative subcutaneous shunt catheter migration

BACKGROUND: Spinal catheter migration into the subcutaneous tissue is common after lumboperitoneal shunt (LPS) placement. This study proposed a new method (i.e., wrapping fascia around the catheter like a sheath) to prevent LPS spinal catheter migration. METHODS: After a LPS spinal catheter was inserted under routine fluoroscopic guidance, and the paravertebral muscle fascia was closed, the fascia was sutured to wrap the catheter like a sheath using intermittent sutures. RESULTS: Before the introduction of this technique, the rate of LPS spinal catheter subcutaneous migration was 4.6%. In this study, following LPS shunt placement in 18 consecutive patients with normal pressure hydrocephalus, no further spinal catheter migrations were observed. CONCLUSION: This novel method of “wrapping the LPS catheter with intermittent suture like a sheath” was found to be safe and effective for preventing further spinal catheter subcutaneous migration.