The efficacy and limitation of lumboperitoneal shunt in normal pressure hydrocephalus

To investigate whether the efficacy of the lumbar-peritoneal (LP) shunt is sustainable, we measured the outcomes of patients with idiopathic NPH (iNPH) preoperatively and postoperatively.

We retrospective reviewed records of 58 patients with iNPH from 2013 to 2015. Exclusion of 7 patients expired, 1 patient shunt infection, and 8 patients was loss of follow-up. In the remaining 42 patients, the mood, talking response, movement, attention, recalling memory, and mini-mental state examination (MMSE), representing patient outcomes, were measured. All of whom were follow-up for 3 years.

Mood (1.91 ± 0.30), talking response (1.98 ± 0.15), movement (1.71 ± 0.51), attention (1.95 ± 0.22), and recalling memory (1.86 ± 0.35) were significantly improved after surgery (1 week;p <  0.0001). However, the indicators significantly declined after 3 years (mood: 0.31 ± 0.52, talking response: 0.50 ± 0.59, movement: 0.17 ± 0.38, attention: 0.40 ± 0.59, recalling memory: 0.21 ± 0.42). The MMSE was also significantly improved after 3 months of surgery (17.9 5 ± 2.80 vs. 25.02 ± 3.36; p <  0.0001). However, it declined after 3 years (17.83 ± 3.66; p = 0.83).

The iNPH is considered potentially reversible. Our data supported that the LP shunt was efficient in the short term. However, the neurological degeneration was still progressive.