Lumbar Puncture

Your doctor believes you need a lumbar puncture or spinal tap.

Why do you need a Lumbar Puncture?

The brain and spinal cord are surrounded by a water-like fluid. This is called cerebral spinal fluid. Injuries and infections of the brain or spinal cord change this fluid. Studying your spinal fluid helps your doctor diagnose the cause of your symptoms.

How is a spinal tap performed?

Spinal fluid flows around your brain and down and up through the spinal canal of your back all the way to base of your back. Your spinal cord a nerve bundle runs only part way down your back. Your doctor will give you a small shot of anesthetic in your lower back to numb the area. A needle will then be inserted between the bones of your lower back. This area is below the spinal cord or nerve bundle. About a teaspoon of spinal fluid can then be drained and sent to the lab for study.

Are there alternatives to a lumbar puncture?

Unfortunately there is really no other way to see or study spinal fluid besides a lumbar puncture. While CT scans and MRI show the brain quite well, they do not show cellular changes like infection. Infections in the brain can be deadly and a lumbar puncture can insure that the infection is found.

Are there any risks or complications of a lumbar puncture?

The lumbar puncture is done below the spinal cord so itcant be damaged. But there are nerves in the lower back. Sometimes these are poked by the needle causing a shooting pain or pressure but not permanent damage. Your doctor will take every precaution to avoid exposing you to germs. But anytime a needle is inserted through the skin, there is a slight risk of infection. The most common complication of a lumbar puncture is a headache. While these occur in up to 30% of patients, most resolve within 24 hours without any special treatment.

What precautions are taken to avoid complications?

By using a small needle, carefully placed in the lower back your doctor will try to avoid injury to or pain from nerves. Your doctor will clean and sterilize your back, cover it with sterile drapes and use sterilized gloves to avoid infection. Spinal headaches are caused by spinal fluid leaking after the needle is withdrawn. Special spinal needles are used to help avoid leaks.

Do you consent to having a lumbar puncture?

While there are risks of a lumbar puncture, your doctor believes the importance of obtaining your spinal fluid for testing outweighs the risks. Now that you understand why the lumbar puncture is to be done, how it will be done, and the possible risks, your doctor needs your consent to proceed.