• Xudong Ma, Xuehai Fan, Wenqinyi Yang, Jiahe Guo, Ziwei Zhou, Dong Wang, Yimeng Wu, Ningnannan Zhang, Guozhi Song, Yan Xing, Xiuyun Liu, Kai Yu, and Huijie Yu.
• Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
• World Neurosurg. 2024 Nov 20.

BackgroundVentriculoperitoneal (VP) shunt surgery is the primary treatment for patients with idiopathic normal pressure hydrocephalus (iNPH). This study compares the outcomes of VP shunt placement using electromagnetic (EM) navigation versus standard methods in iNPH patients, focusing on catheter accuracy and post-operative complication rates.MethodsThis retrospective study included 31 iNPH patients who underwent standard shunts using anatomical landmarks and 50 iNPH patients who underwent EM-guided shunts. Parameters assessed included shunt placement grade, catheter tip position, catheter angle, puncture attempts, operative duration, postoperative infection rates, intraparenchymal hemorrhage rates, and shunt malfunction rates. Patients were followed up at 3, 6, 12, and 24 months after surgery or until shunt failure.ResultsIn the EM-guided group, a higher percentage of Grade 1 shunt placements (92% vs. 71%, p = 0.03) and fewer Grade 3 placements (2% vs. 13%, p = 0.068) were observed. The catheter tip position at the foramen of Monro was significantly more accurate (p < 0.001), with smaller lateral catheter deviation angles in both coronal (19.69° vs. 24.2°, p < 0.0001) and sagittal sections (21.75° vs. 39.3°, p < 0.01). The EM-guided group had fewer puncture attempts, shorter operative durations, lower incidence of intraparenchymal hemorrhage (p < 0.01), and fewer shunt malfunctions over the 2-year follow-up period (2% vs. 26%, p = 0.0003).ConclusionsThe use of EM navigation in VP shunts for iNPH patients improves catheter placement accuracy, reduces postoperative complications and shunt malfunction rates, and provides precise and individualized surgical treatment.Copyright © 2024. Published by Elsevier Inc.

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