Lumbar puncture

A lumbar puncture (LP), also known as a spinal tap, is a medical procedure where a needle is inserted into the lower part of the spinal column to extract cerebrospinal fluid (CSF) for diagnostic or therapeutic purposes. The procedure involves accessing the subarachnoid space in the lumbar region of the spinal cord, below the level where the spinal cord ends, to avoid injury to the spinal cord itself.

Procedure

The lumbar puncture is typically performed with the patient lying on their side with their knees drawn up towards their chest, or seated and leaning forward. After cleaning the lumbar area with an antiseptic solution, local anesthesia is applied to numb the area. A thin needle is then carefully inserted between the vertebrae, through the dura and arachnoid membranes, and into the subarachnoid space.

Indications

Lumbar puncture is often performed to collect CSF for diagnostic testing. It is commonly used in the diagnosis of conditions such as meningitis, subarachnoid hemorrhage, and certain neurological disorders, where abnormalities in the composition of the CSF may provide important clues. It may also be used therapeutically, such as in the administration of medications like chemotherapy drugs, or to relieve pressure in the CSF space due to conditions like idiopathic intracranial hypertension.

Risks and Complications

While generally considered safe, lumbar puncture is not without risk. Potential complications include post-dural puncture headache, infection, bleeding, and damage to the spinal cord or nerves. Serious complications are rare but can include brain herniation in patients with increased intracranial pressure.

Summary

A lumbar puncture is a crucial tool in modern medicine, allowing for the diagnosis and treatment of a range of neurological conditions. While the procedure carries some risks, it is generally safe when performed by trained professionals on appropriately selected patients.

See Also

• Spinal Cord
• Meningitis
• Subarachnoid hemorrhage

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