Clinical predictors of the need for ventriculoperitoneal shunt placement in myelomeningocele patients

Abstract

Background: There is some degree of ventriculomegaly that occurs after myelomeningocele (MMC) repair. Aim: This study aimed to identify the clinical predictors of the need for ventriculoperitoneal shunt placement in MMC patients to avoid unnecessary shunting with its complications. Methods: This retrospective cohort study included infants with lumbosacral myelomeningocele who were managed in the neurosurgical department in Ain Shams University Hospital from January 2016 to December 2018. The study was approved by the Research Ethics Committee of the Faculty of Medicine at our university. Informed consent was obtained as required.Results: Fifty patients met our selection criteria. Twenty-two patients (44%) needed shunts. The statistically significant clinical predictors of shunt placement in MMC patients were crossing the HC percentile for age, tense AF, sun setting of eyes, persistent vomiting, delayed or deteriorating developmental milestones, and CSF leakage from the MMC wound.Conclusion: Applying the statistically significant clinical predictors of shunt placement to decide shunt placement in MMC patients is of utmost importance to avoid unnecessary shunting.