Lumbar Puncture (Spinal Tap, Cerebrospinal Fluid Tap, Cerebrospinal Fluid Analysis)

Administer dye for diagnostic imaging studiesDrain spinal fluid to lower intracranial pressure Administer medications (such as chemotherapy or anesthesia ) Risk Factors for Complications during the ProcedureA local infection at the site where the needle would be insertedElevated pressure in the skull What to Expect Prior to Procedure Possibly, a CT scan a type of x-ray that uses a computer to make pictures of structures inside the body Your back will be cleaned at the site where the needle will be inserted During ProcedureAnesthesia will be administered. AnesthesiaThe procedure uses local anesthesia. Description of the ProcedureYou lie on your side with your knees drawn up to your abdomen. A needle is inserted into your spinal canal through your lower back. A sample of cerebrospinal fluid is withdrawn through the needle. The pressure of the CSF is measured. If you experience discomfort during the procedure, the needle may need to be repositioned.If you have a problem with the lower back that prevents you from assuming the curled position, the cerebrospinal fluid may be withdrawn from the top of the spine at the back of the neck, a procedure known as a cisternal puncture.

After ProcedureCerebrospinal fluid is sent to a lab for analysis. You lie down for 10-15 minutes, and then you can leave, unless you have a severe headache. How Long Will It Take?The procedure typically takes 30 minutes or more. Will It Hurt?Overall, discomfort is minimal to moderate. The anesthetic will sting when first injected, and there is usually a little pain when the needle is first inserted, but it should subside in a few seconds. Possible ComplicationsLocal bleedingHeadacheBackacheAllergic reaction to the anesthetic The complications listed below are rare: Herniation and deathLocal infectionPain or abnormal burning, pricking, or tingling sensations in your legsSpinal, epidural, subdural, or subarachnoid hematomas (blood clots)Inflammation of the arachnoid mater, a delicate membrane lining the nervous systemTemporary paralysis of a cranial nerveRupture of the soft, central portion of the intervertebral disk, called the nucleus pulposusDelayed formation of intraspinal epidermoid tumorsMeningitis Average Hospital StayA lumbar puncture is typically an outpatient procedure. It does not require a hospital stay. Postoperative CareDrink extra fluids for the next 24 hoursRest and remain quiet for at least the next 24 hours OutcomeBased on the pressure and contents of the CSF, a diagnosis can often be made.

High pressure can indicate swelling, bleeding, a tumor, or hydrocephalus . The CSF is also analyzed for antibodies, bacteria, viruses, fungi, blood, cancer cells, excess protein, and white blood cells. Normal cerebrospinal fluid is clear and contains no blood. If there is blood or a yellowish color is present, it may indicate spinal cord obstruction or bleeding in the brain or spinal cord. Call Your Doctor If Any of the Following OccursSevere headache or headache lasting for more than 24 hoursNausea or vomitingSigns of infection, including fever and chillsRedness, swelling, increasing pain, bleeding, or discharge from the site of the spinal tapTinglingNumbness or pain in your lower back and legsProblems with urination RESOURCES: American Academy of Family Physicianshttp://www.aafp.org Nemours Foundationhttp://kidshealth.org/parent CANADIAN RESOURCES: About Kids Healthwww.aboutkidshealth.ca BC Healthguidewww.bchealthguide.org References: The PDR Family Guide Encyclopedia of Medical Care . Three Rivers Press; 1997. The University of Iowa website. Available at: http://www.uiowa.edu/ . Last reviewed February 2008 by Robert Leach, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.