Re: Lumbar Puncture

Posted By CCF Neuro MD on May 27, 1997 at 11:27:48:

In Reply to: Lumbar Puncture posted by Susan Cotton on May 21, 1997 at 13:37:41:







: What are the pro's and con's a patient should be aware of when evaluating informed consent to a spinal tap?



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Hello Susan,
Lumbar punctures or spinal taps as they are also known can be a very helpful diagnostic tool to physicians.  I'll describe to you how this procedure is preformed at the Cleveland Clinic Foundation.  This procedure is typically done at the bedside with the patient lying on their side or in a sitting position.  The benefit of the lying position is that one can messure the CSF pressure when the patient is lying down whereas this reading is not accurate if done in the the sitting postion.  The area of the lower spine is cleaned with an antispetic solution and made sterile.  Then a spinal needle is inserted in between the 4th and 5th lumbar spinous porcess after infiltrating the area with a local anesthetic.  Once the needle is in the subarachnoid space, CSF pressure is measured and CSF fluid is collected into several conatiner.  After the fluid is obtained the needle is withdrawn and the paitent is instructed to lie on their back for some period of time.  There are various neurologic disorders that can be
diagnosed from studying the spinal fluid.  It is routinely used to help in the diagnosis of meningitis, subarachnoid bleeding, multiple sclerosis, CNS vasculitis just to name a few.  When done in the proper way there are very few potential complications that can occur.  Bleeding and infection being the most obvious potential complications.  More often however patients can develop a postspinal headache which can vary from being a minor problem to one requiring another procedure which uses clotted blood to seal the leak of spinal fluid.  If you or some you know is having this procedure done I would strongly advise you to speek with the physician performing the procedure and get informed consent from him/her.  A lumbar puncture is generally a safe procedure when done by experienced hands.