In addition, a lumbar puncture may be used to measure the pressure of the CSF. The healthcare provider uses a special tube called a manometer to measure s the pressure during a lumbar puncture. Finally, a lumbar puncture may be done to inject medicine directly into the spinal cord. These include:. Your healthcare provider may have other reasons to recommend a lumbar puncture.
Because this procedure involves the spinal cord and brain, the following complications may occur:. There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure. I f you are having a lumbar puncture at Johns Hopkins Hospital or Bayview Medical Center, a neuroradiologist or radiology nurse will contact you by phone two or three days prior to your lumbar puncture to discuss the procedure and answer any questions you may have.
Please inform the neuroradiology physician if:. Other options should be discussed with you and your doctor. A gown will be provided for you. However, the procedure may also be done while you remain in your clothes from home. For this reason, try to wear non-restrictive, comfortable clothing and slip on shoes if possible. Please remove all piercings and leave all jewelry and valuables at home. If you are not sure if it is safe for you, contact your primary care provider or referring provider.
However, on the day of the procedure, do not eat for three hours before the procedure. You may have liquids and can take your usual medications unless previously advised to hold certain medications in preparation for the lumbar puncture. Please bring a current list of your medications and allergies with you.
This is for your safety and comfort. A lumbar puncture procedure may be done on an outpatient basis or as part of your stay in a hospital.
Procedures may vary depending on your condition and your doctor's practices. Some healthcare providers may prefer to do this procedure at the bedside or may opt to have it done using a type of live X-ray called fluoroscopic guidance. You may have discomfort during a lumbar puncture. Your healthcare providers will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.
This helps reduce the incidence of a headache. You will be allowed to roll from side to side as long as your head is not elevated. A lumbar puncture is where a thin needle is inserted between the bones in your lower spine. It should not be painful, but you may have a headache and some back pain for a few days.
Your doctor or nurse should explain what's going to happen and why you need a lumbar puncture. A lumbar puncture takes around 30 to 45 minutes, but you'll need to stay lying down at the hospital for at least another hour while the nurses monitor you.
If a child is having a lumbar puncture, a parent may be allowed to stay in the room in some cases. Talk to your child's doctor or nurse about whether this will be possible. You may be asked to change into a hospital gown, although in some cases you may have the procedure while wearing your own clothing. There are a few possible positions for this test. Usually, you lie on your side with your knees drawn up to your chest, or you sit and lean forward on a stable surface.
These positions flex your back, widening the spaces between your vertebrae and making it easier for your doctor to insert the needle. The procedure usually lasts about 45 minutes. Your doctor or nurse may suggest lying down after the procedure. Sometimes, an ultrasound may be used as a guide during the procedure on infants and young children. The ultrasound can help prevent inserting the needle too far. The spinal fluid samples are sent to a laboratory for analysis.
Lab technicians check for a number of things when examining spinal fluid, including:. Lab results are combined with information obtained during the test, such as spinal fluid pressure, to help establish a possible diagnosis.
Your health care professional generally gives you the results within a few days, but it could take longer. Ask when you can expect to receive the results of your test.
Write down questions that you want to ask your doctor or nurse. Don't hesitate to ask other questions that may come up during your visit. In experienced hands, a lumbar puncture is a relatively safe procedure. Proper positioning of the patient is extremely important. The patient is asked to lie on their side, with their back toward the examiner and then curl into a ball.
This involves the patient flexing their neck and lower spine, whilst drawing up their thighs toward their chest. The shoulders and pelvis should be vertically aligned without forward or backward tilt. Therefore a lumbar puncture is generally performed at or below the L3-L4 interspace. As a general anatomical rule, the line drawn between the posterior iliac crests often corresponds closely to the level of L3-L4.
The interspace is selected after palpation of the spinous processes at each lumbar level. Once the area for needle insertion has been ascertained, the examiner puts on a mask and sterile gloves — this decreases the risk of infection. The skin is then cleansed with alcohol and usually an iodine based disinfectant and the area is draped with a sterile cloth. The lumbar puncture needle is typically a 20 — 22 gauge needle and it is inserted into the target area and slowly advanced.
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