Unexpected Decrease in Shunt Surgeries Performed during the Shelter-in-Place Period of the COVID-19 Pandemic
Related Experiment Video
Updated: Nov 22, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Nealen Laxpati1, David P Bray1, Jennifer Wheelus1,2
1Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, United States of America.
Insights
During the COVID-19 pandemic, cerebrospinal fluid (CSF) shunt surgeries unexpectedly decreased, especially revision surgeries. This suggests environmental factors related to the pandemic altered shunt malfunction presentation rates.
Area of Science:
- Neurosurgery
- Public Health
- Epidemiology
Background:
- Cerebrospinal fluid (CSF) shunt malfunctions are common in neurosurgery.
- The COVID-19 pandemic prompted shelter-in-place orders globally.
- It was hypothesized that CSF shunt malfunction incidence would remain stable during this period.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on CSF shunt surgery volumes.
- To compare shunt surgery numbers during the pandemic lockdown with previous years.
Main Methods:
- Retrospective analysis of shunt surgeries at a single institution.
- Data collected for a 28-day period starting mid-March, from 2015 to 2020.
- Surgeries stratified by elective vs. emergent, presentation, and type (e.g., revision).
Main Results:
- A consistent increase in shunt surgeries was observed from 2015 to 2019.
- In 2020, 32 shunt surgeries were performed during the 28-day period, with 15 emergent cases from outpatient settings.
- A statistically significant decrease in revision shunt surgeries was noted in 2020.
Conclusions:
- The COVID-19 pandemic was associated with an unexpected reduction in overall shunt surgeries.
- Revision shunt surgeries saw a particularly notable decrease.
- Pandemic-related environmental factors may influence the presentation rates of CSF shunt malfunctions.
Background:
It is expected that the incidence of cerebrospinal fluid (CSF) shunt malfunctions would remain unchanged during the shelter-in-place period related to the COVID-19 pandemic.
Objective:
To examine the number of shunt surgeries performed in a single institution during this time interval in comparison to equivalent periods in past years.
Methods:
The numbers of elective and emergent/urgent shunt surgeries performed at a single institution were queried for a 28-d period starting on the third Monday of March, between years 2015 and 2020. These were further stratified by how they presented as well as the type of surgery performed.
Results:
During the 28-d period of interest, in the years between 2015 and 2020, there was a steady increase in the number of shunt surgeries performed, with a maximum of 64 shunt surgeries performed in 2019. Of these, approximately 50% presented in urgent fashion in any given year. In the 4-wk period starting March 16, 2020, a total of 32 shunt surgeries were performed, with 15 of those cases presenting from the outpatient setting in emergent/urgent fashion. For the surgeries performed, there was a statistically significant decrease in the number of revision shunt surgeries performed.
Conclusion:
During the 2020 COVID-19 pandemic, there was an unexpected decrease in the number of shunt surgeries performed, and particularly in the number of revision surgeries performed. This suggests that an environmental factor related to the pandemic is altering the presentation rate of shunt malfunctions.
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