Early postoperative lumbar catheter severing in a lumboperitoneal shunt due to bite-off by the spinous processes following a fall on the buttocks: illustrative case

腰椎穿刺术后早期腰椎导管断裂,系因跌倒臀部着地后棘突咬断所致:病例报告

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Abstract

BACKGROUND: Rupture of the lumbar catheter in lumboperitoneal (LP) shunts is rare and typically occurs due to long-term mechanical stress. The authors describe an unusual case of early postoperative lumbar catheter severing after a fall on the buttocks. OBSERVATIONS: A 78-year-old woman underwent LP shunt placement for communicating hydrocephalus after aneurysmal subarachnoid hemorrhage. The lumbar catheter was inserted via a median approach, and the postoperative course was uneventful. However, 2 months after the LP shunt surgery, she accidentally fell on her buttocks in the hospital ward. Radiography showed a rupture of the lumbar catheter due to the shearing force caused by compression of the spinous processes from the impact of the fall. LESSONS: In patients who have undergone catheter placement via a median approach, even within a short period after LP shunt placement, the lumbar catheter that has deteriorated due to "pinch-off" can rupture due to "bite-off" by the spinous processes following a fall on the buttocks. https://thejns.org/doi/10.3171/CASE24509.

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