What Is a Lumbar-Peritoneal Shunt?

A lumbar-peritoneal shunt is a piece of tubing inserted through a surgical procedure performed to relieve pressure in areas of the brain and spinal cord caused by a buildup of fluid applying pressure to the brain. This form of shunt is commonly used to treat intracranial hypertension and the resulting symptoms of vision loss and persistent headaches. The theory behind the use of a lumbar-peritoneal shunt is that excess cerebrospinal fluid is moved from the area in which pressure is being applied to an area where it can be absorbed, such as the cavity of the abdomen.

Surrounding the brain and spinal cord, cerebrospinal fluid is drained from the area of pressure using a thin plastic catheter inserted beneath the skin of the patient. Incisions are made over the location of fluid buildup on the spinal cord or brain and over the location of the abdomen to where fluid is to be drained. After insertion, a catheter will allow the cerebrospinal fluid to drain through a valve left at the end of the plastic tube. The tube is passed through a metal tunneler down to the abdomen.

Problems can result in the patient receiving a lumbar-peritoneal shunt, including infections and meningitis caused by the surgical procedure. Other problems are possible seizures and the movement of blood clots in the legs passing through the body. The use of the lumbar-peritoneal shunt can also result in the brain matter sinking down through the exit hole for the cerebrospinal fluid. This condition is called chiari malformation and can block the hole used for the shunt and trap fluid against the brain. Though complications are rarely seen, blockages in the shunt are occasionally reported.

Conditions that often require the use of a lumbar-peritoneal shunt include the leakage of cerebrospinal fluid from the spine and cranial area of the body. Skull fractures over the sinus area and in the base of the skull, for example, can be difficult to heal, sometimes growing over time. Programmable lumbar-peritoneal shunts can regulate the drainage of cerebrospinal fluid from the pressurized location of the brain, reducing problems with too much fluid being drained and absorbed into the abdominal cavity.

The shunt is often inserted instead of another form known as the ventriculoperitoneal, that is inserted into the cranium. Advantages are found with the lumbar-peritoneal shunt because it is inserted on the outside of the skull, making the shunt insertion easier to complete. Conclusions are difficult to draw on the effectiveness and safety of the shunt because of little completed research into the medical equipment.