Lumbar Puncture Preparation – Getting Ready For The Procedure

Lumbar puncture preparation involves following a few basic safety measures. If you remember these basic precautions, you can greatly reduce the risk of facing any adverse lumbar puncture side effects after the test is carried out.

During the procedure, the patient will be required to lie down with the knees pulled up against the chest, or sit on the edge of a chair and lean forward. Either way, the intent is to expose the lumbar region (lower back).

The doctor will then clean and disinfect a small area to insert the spinal needle. A local anesthetic will first be applied to the area, and then a hollow needle will be inserted into the spinal canal in order to extract some Cerebrospinal Fluid (CSF).

The Basics On Lumbar Puncture Preparation

A Lumbar Puncture is basically a diagnostic procedure, but in some situations, it might serve other functions. It is mainly used to diagnose neurological disorders and infections like meningitis that affect the nervous system.

Lumbar Puncture Preparation

During lumbar puncture preparation, you’ll be briefed about the spinal needle

This is a safe procedure and seldom results in any complications, and to reduce your risks further, you must take certain precautions. Your physician will have the authority to advise some precautions. Here are a few lumbar puncture preparation tips that you should remember:

  • You must inform your doctor of any pre-existing medical conditions like problems related to blood clotting.
  • You must inform your doctor if you are allergic to any medicines, such as certain anesthetics.
  • If you take any anticoagulant medicine or other blood thinners like aspirin, inform your doctor of this, before the procedure.
  • If you take any herbal remedies, you must tell your doctor what these are. Some herbal remedies can act as blood thinners.
  • If you are pregnant, or suspect that you might be pregnant, inform your doctor.

Mandatory Steps Before Lumbar Puncture

During the lumbar puncture preparation phase, you will be asked to sign a consent form that details the risks involved. If you have any concerns about these, you should discuss them with your doctor.

Also, before the procedure starts, you will have to empty your bladder. The hospital staff will remind you about this an hour before the procedure.

Other Lumbar Puncture Preparation Tips

  • The patient should avoid eating or drinking up to four hours before the procedure is scheduled.
  • The patient must come prepared to stay in bed-rest for 24 hours after a lumbar puncture.
  • The patient should be in a relaxed frame of mind before the procedure. This results in reduced muscular tension, making it easier for the needle to pass through the tissues to the spinal canal.

Sometimes, additional procedures like a CT scan might be necessary before a lumbar puncture. If there are any indications that a patient might have a tumor or swelling in the region of the brain, a CT scan should be performed. This will confirm or eliminate the existence of any inflammation, tumor or other growth in or around the brain.

If such a problem exists, a lumbar puncture test might result in increased intracranial pressure, and for this reason, a doctor might explore possible alternative procedures to avoid a lumbar puncture.

Lumbar puncture preparation is easy as long as the doctor’s instructions are followed. Remember the points listed above, and you should be easily able to avoid any complications.

Lumbar Puncture Side Effects – Potential Risks and Complications

Serious lumbar puncture side effects are rare, as it is a relatively safe procedure. This procedure, used to extract cerebrospinal fluid for analysis, is a very important diagnostic tool in many nervous disorders and diseases. However, similar to most medical procedures, there are possibilities of complications. Some of the lumbar puncture risks have been discussed below.

Lumbar Puncture Side Effects

The procedure is performed even on infants as lumbar puncture side effects are minimal

Lumbar Puncture Side Effects You Should Know About

Lumbar Puncture Risk #1: Post Lumbar Puncture Headache

The most common among lumbar puncture side effects is a headache. This effect is felt by around 30% of people who have undergone the procedure. The headache can range from moderate to severe, and it can be accompanied by dizziness, nausea and vomiting.

The headache usually starts from a few hours to two days after the procedure has been performed.

It can last for several days, or it can disappear within a few hours. The main cause of this headache is the leakage of spinal fluid into the surrounding tissues.

Lumbar Puncture Risk #2: Back Pain

In some cases, this procedure can cause back pain. After the procedure, you may feel tenderness or pain in your lower back that might extend down to the back of your legs, and this is nothing to be concerned about.

Lumbar Puncture Risk #3: Bleeding

Rarely, an injury to the blood vessels in the region around the spinal canal can occur when the needle is inserted. This might result in localized bleeding, and this is one of the rare lumbar puncture side effects.

Bleeding can also occur if the patient has a blood clotting disorder.

Lumbar Puncture Risk #4: Herniation

Intracranial pressure due to the presence of a tumor or other causes can cause a brainstem herniation. Extraction of a little CSF can increase the pressure on the brain, pressing it down towards the spinal cord. This is an extremely rare occurrence.

Tips To Prevent Lumbar Puncture Side Effects

  • Medical History: The patient needs to give his full medical history to the doctor before the procedure is done. This will ensure that the doctor knows if the patient has any medical conditions (like a blood clotting problem) before the Lumbar Puncture is performed.
  • Tests to Eliminate Possible Complications: Certain diagnostic procedures like a CT scan might be performed to identify any possible risk due to a preexisting condition. For instance, if there is a suspicion of a tumor in the region of the brain, a CT scan can help confirm or eliminate it. If a tumor is present, it increases the risk of brainstem herniation.
  • Medications: If the patient is taking anticoagulant or other blood thinner medications, it can increase the risk of post procedural bleeding.
  • Rest: Patients are often advised to rest for a few hours after a Lumbar Puncture has been performed. This can help reduce the chances of the patient experiencing a post lumbar puncture headache.

The lumbar puncture is a vital diagnostic tool for detecting critical disorders that are related to the central nervous system. It is a safe procedure, but occasionally, it can push up some complications. Taking a few precautions before and after the procedure can greatly help reduce the risk of lumbar puncture side effects.

The Lumbar Puncture Test And Its Use As A Diagnostic Procedure

A lumbar puncture test or spinal tap is the process of extracting Cerebrospinal Fluid (CSF) from the lower end of the spine. The Cerebrospinal Fluid is a liquid that surrounds and cushions the brain and the spinal column.

Analyzing this liquid can help doctors detect the cause of diseases that affect the central nervous system.

The Lumbar Puncture Test As A Diagnostic Tool

The brain and the spinal cord are extremely sensitive parts of the human body. To protect them and to keep them functioning normally, they are surrounded by a membrane called the meninges.

Inside this membrane, a liquid called the Cerebrospinal Fluid (CSF) surrounds the spinal cord and the brain. This provides further protection, cushioning the region against any form of shock. The manufacture, re-absorption, and replenishment of CSF is a continuous process.

Lumbar Puncture Test

During the Lumbar Puncture Test, Cerebrospinal Fluid is collected.

The body continually manufactures CSF from blood plasma. This CSF eventually gets back into the bloodstream and gets reabsorbed. Newly formed CSF replenishes the CSF lost through re-absorption.

A Lumbar Puncture is the procedure for extracting CSF for analysis. After the lumbar puncture test is carried out, the composition of the CSF is studied for the diagnosis of various neurological conditions.

Local anesthesia is administered before the lumbar puncture test, and a small amount of CSF is collected through a needle. By attaching a thin plastic tube to the needle, the pressure of the CSF can be monitored. After gauging the pressure, the CSF that flows out through the hollow needle is collected in sealable test tubes. The needle is withdrawn when an adequate amount of CSF has been extracted. The fluid thus obtained is sent to the lab for analysis.

Why Do Doctors Tap Into The Lumbar Region?

The lower back or the lumbar region is chosen for a specific reason.

The spinal cord ends several inches above the lower end of the spinal canal. This leaves a space where the CSF can be extracted safely without risking the chance of an injury to the spine. This is mainly why doctors collect CSF from the lumbar region.

What Can A Lumbar Puncture Test Help Detect?

The Cerebrospinal Fluid is composed of proteins, glucose, and other components that can also be found in the blood. Studying the glucose level, the type of proteins, and the type of white blood cells in the CSF can help doctors identify infections and other conditions affecting the central nervous system. Some definite conditions that the lumbar puncture test can help diagnose are:

  • Critical Infections: Fungal, viral, or bacterial, like Meningitis, Syphilis, and Encephalitis.
  • Subarachnoid Hemorrhage: Bleeding in the region of the brain
  • Cancers: Cancers of the brain or the spinal cord
  • Inflammatory Conditions: Neurological inflammatory disorders like Guillain-Barre Syndrome and Multiple Sclerosis

Analyzing the CSF is the best way to detect diseases like meningitis, and for this reason, the lumbar puncture test is a vital diagnostic tool for detecting critical disorders and diseases of the central nervous system. Of course, the procedure must be preceded by proper lumbar puncture preparation measures so as to avoid any potential lumbar puncture side effects.

What Is A Lumbar Puncture? – An Introduction to the Procedure

The diagnosis of diseases related to the brain and spinal cord might require a study of the composition of the spinal fluid. Performing a lumbar puncture allows the doctor to extract a sample of the spinal fluid for analysis, and this is essentially the need behind the practice.

What Is A Lumbar Puncture?

A Lumbar Puncture is the process of inserting a hollow needle into the spinal canal, between two vertebrae. It is done to extract Cerebrospinal Fluid from the lower back, for diagnostic purposes. The fluid extracted is analyzed to diagnose certain medical conditions like meningitis. In rare cases, a Lumbar Puncture can also be used as a therapeutic procedure.

Cerebrospinal Fluid is a clear and colorless liquid, and this fluid surrounds the brain and the spine.

It provides buoyancy to the brain, and acts as a shock absorber. It delivers nutrients to the brain and removes waste. As it flows between the cranium and the spine, it compensates for fluctuations in the blood volume within the intracranial region.

Lumbar Puncture

Lumbar Puncture in the early twentieth century

The History Behind The Procedure

The Lumbar Puncture was first performed by Dr. Heinrich Quincke, of Kiel, Germany, in 1891. He initially performed this procedure to drain excess fluid from around the brain. This was done as a treatment for hydrocephalus in babies.

Soon, though, Dr. Quincke recognized the potential use of analyzing the extracted liquid (CSF) in detecting the causes for other disorders that could affect the brain and the nervous system. Traditionally, the main use of a spinal tap as a diagnostic procedure has been to diagnose meningitis. This is a dangerous infection, but if it is detected on time, it can be treated.

Why Is A Lumbar Puncture Performed?

As a Diagnostic Procedure

  • The most common reason for doing a Lumbar Puncture test is to diagnose meningitis. The CSF is analyzed to see if the bacteria responsible for causing meningitis are present.
  • This procedure can help in finding the cause for inflammation or bleeding in the region of the spinal cord or the brain.
  • It also helps diagnose other brain and spine related diseases like multiple sclerosis or Guillain-Barre Syndrome.

As an Aid to Other Medical Procedures

  • A Lumbar Puncture might be used to administer anesthesia into the cerebrospinal fluid (CSF). This is done in the treatment of leukemia and other types of cancers related to the central nervous system.
  • This procedure is used to insert a dye into the CSF. This cerebrospinal fluid is clear and colorless. By inserting a dye, it can be made visible in X-Ray images. This is done to determine if a disc or a cancerous growth is obtruding into the spinal canal.

As a Therapeutic Procedure

  • On rare occasions, a spinal tap or lumbar puncture can be used as a therapeutic treatment. This procedure could be used to lower pressure on the brain by draining excess CSF.

The Lumbar Puncture is a well-known diagnostic procedure and when it is performed under sterile and safe conditions, the risks involved and the lumbar puncture side effects can be minimal.