Lumbar puncture

Lumbar puncture
Wikipedian getting a lumbar puncture (2006).jpg
Lumbar puncture in a sitting position. The reddish-brown swirls on the patient's back are tincture of iodine (an antiseptic).
Other namesSpinal tap

Lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF) for diagnostic testing. The main reason for a lumbar puncture is to help diagnose diseases of the central nervous system, including the brain and spine. Examples of these conditions include meningitis and subarachnoid hemorrhage. It may also be used therapeutically in some conditions. Increased intracranial pressure (pressure in the skull) is a contraindication, due to risk of brain matter being compressed and pushed toward the spine. Sometimes, lumbar puncture cannot be performed safely (for example due to a severe bleeding tendency). It is regarded as a safe procedure, but post-dural-puncture headache is a common side effect if a small atraumatic needle is not used.[1]

The procedure is typically performed under local anesthesia using a sterile technique. A hypodermic needle is used to access the subarachnoid space and collect fluid. Fluid may be sent for biochemical, microbiological, and cytological analysis. Using ultrasound to landmark may increase success.[2]

Lumbar puncture was first introduced in 1891 by the German physician Heinrich Quincke.

  1. ^ Maranhao, B.; Liu, M.; Palanisamy, A.; Monks, D. T.; Singh, P. M. (17 December 2020). "The association between post‐dural puncture headache and needle type during spinal anaesthesia: a systematic review and network meta‐analysis". Anaesthesia. Wiley. 76 (8): 1098–1110. doi:10.1111/anae.15320. ISSN 0003-2409. PMID 33332606.
  2. ^ Gottlieb, M; Holladay, D; Peksa, GD (January 2019). "Ultrasound-assisted Lumbar Punctures: A Systematic Review and Meta-Analysis". Academic Emergency Medicine. 26 (1): 85–96. doi:10.1111/acem.13558. PMID 30129102.

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