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A lumbar puncture involves the insertion of a hollow needle through the lower back, usually between the fourth and fifth lumbar vertebrae, into the subarachnoid space of the spinal canal. The procedure is performed using sterile technique, under local anesthesia, and can be done on an outpatient basis. In general, the most common reasons for a lumbar puncture are to collect cerebrospinal fluid (CSF) to assist with diagnosis or to administer medications.
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Source: Medical Disability Advisor
| Lumbar puncture may be done to collect a sample of the liquid that cushions the brain and spinal cord (cerebrospinal fluid, CSF), measure pressure inside the spinal column, administer medications, or administer contrast material for radiographic visualization for certain tests (myelography).
Cerebrospinal fluid is collected and analyzed to help diagnose a number of different diseases and conditions, including subarachnoid hemorrhage, infections such as meningitis or encephalitis, Guillain-Barré syndrome, polio, certain cancers such as leukemia and lymphoma, and multiple sclerosis. A lumbar puncture is also used to measure the pressure of the CSF inside the spinal column in order to determine the presence of infection, tumors, or swelling in the brain. Certain medications such as local anesthetics for surgery, pain medications, antibiotics, corticosteroids, or cancer drugs may be administered directly into the spinal canal using a lumbar puncture. |
Source: Medical Disability Advisor
| During a lumbar puncture, the individual lies on his or her side with the knees drawn up to the abdomen and the forehead bent towards the knees. This position allows for maximum separation of the vertebrae in the lower back, allowing the needle to be inserted more easily. A local anesthetic is injected into the skin near where the needle will be inserted to numb the area. The needle is then inserted through the lower back and into the spinal canal. Depending on the reason for the procedure, a small sample of CSF may be extracted (which takes about 5 minutes), and the needle will be removed. If the purpose of the lumbar puncture is to administer medication, the needle will be left in place, and tubes will be attached through which the medication can enter the spinal canal. If myelography (x-ray examination of the spinal canal, nerve roots, and spinal cord) is to be performed, contrast material will be injected through the needle. If the pressure of the CSF is being measured, a device called a manometer is attached to the lumbar puncture needle. Following the procedure, a bandage will be applied to the puncture site, and the individual will be required to remain in a reclining position for some time (anywhere from 15 minutes to several hours). If a CSF sample has been taken, the body naturally replaces the amount lost in about 1 hour. The individual should not engage in strenuous activities for 24 hours following the procedure. |
Source: Medical Disability Advisor
| Most individuals who undergo lumbar puncture have no complications from the procedure and experience a full recovery in 1 to 2 days. In individuals who experience headache, bed rest, increased fluid intake, and pain medication normally relieve symptoms within 1 week. |
Source: Medical Disability Advisor
| The most common complication following lumbar puncture is headache, which occurs in 10% to 25% of individuals and normally lasts 1 to 2 days (Spengler). The headache, sometimes referred to as a "spinal headache," is treated with bed rest, increased fluid intake, and over-the-counter analgesics such as ibuprofen. In a small number of individuals, the spinal headache may become severe and persistent due to CSF leakage. In such cases, some physicians recommend a "blood patch," a procedure in which a small quantity of the individual's own blood is injected into the epidural space to "patch" or block the hole in the dura for evaluation and/or to cause the injection site to heal or clot more quickly and stop the leakage. Some individuals experience discomfort or a short period of mild to moderate pain during a lumbar puncture. Other less common complications include bleeding into the spinal canal, brain herniation (displacement of the brain outside of the skull secondary to increased pressure), accidental damage to the spinal cord (particularly if the individual moves during the procedure), hypersensitivity to the anesthetic used, infection, and pain or tingling in the back or leg. |
Source: Medical Disability Advisor
| Individuals who undergo lumbar puncture are advised to rest and avoid all strenuous activity for the first 24 hours following the procedure. Most individuals will experience no complications and may then return to normal activities. However, work restrictions and accommodations are usually based on the underlying condition for which the LP was done, as well as on the severity of any complications that might occur. |
Source: Medical Disability Advisor
| Spengler, Renée. "Lumbar Puncture." WebMD.com. Ed. Daniel Greer. 18 Feb. 2003. WebMD Inc. 12 Oct. 2004 <http://my.webmd.com/hw/health_guide_atoz/hw234563.asp>. |
Source: Medical Disability Advisor