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(Cerebrospinal Fluid Analysis; Cerebrospinal Fluid Tap; Spinal Tap)

Definition

A lumbar puncture is a test of the cerebrospinal fluid (CSF) around your spine and brain. This fluid provides protection and nutrition to the brain and nerve cells. It also helps remove waste products from the brain.

Lumbar Puncture Method
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Reasons for Procedure

The test is done to look for anything that is not normal with a person's CSF. It may be done to help diagnose health problems, such as:

  • Brain infection
  • Neurological disorders, such as Multiple sclerosis
  • Bleeding in the brain or spinal cord
  • A buildup of CSF in the brain

It may also be done treat health problems. It can be used to:

  • Give medicine directly to the spine, such as chemotherapy , antibiotics, and anesthesia
  • Deliver dye for imaging studies
  • Drain CSF to lower pressure within the brain

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Infection
  • Bleeding
  • Compression on the brain stem
  • Allergic reaction to the anesthetic

What to Expect

Prior to Procedure

The doctor may do:

Before the procedure:

  • Do not eat or drink anything after midnight the night before.
  • Arrange for a ride to and from the hospital
  • Talk to the doctor about the medicines, herbs, and supplements that you take. Some may need to be stopped up to one week before the procedure.
  • Talk to the doctor about any allergies you may have.

Anesthesia

Local anesthesia will be used most often. It numbs just a small area.

Description of Procedure

You will likely lie on your side with your knees drawn up in front. Some punctures may be done while you sit on the edge of the bed. The site will be cleaned. A needle will be inserted through the lower back and into the spinal canal. A sample of CSF will be taken through the needle.

The pressure of the CSF may be noted during the procedure. If needed, medicines or dyes will be injected. The needle will be removed. A bandage will be placed over the site.

Immediately After Procedure

You will lie down for 10 to 60 minutes. You will often be able to go home after the procedure. If you have a severe headache or need immediate treatment, you may need to stay longer.

How Long Will It Take?

About 30 to 45 minutes from setup to completion

Will It Hurt?

The anesthesia will sting when it is injected. The lumbar puncture will cause pressure in the back.

Post-procedure Care

Rest and home care will be needed for at least 24 hours. Medicine will be given to help with any pain.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • A headache that lasts for more than 24 hours
  • Nausea or vomiting
  • Signs of infection, such as fever and chills
  • Redness, swelling, bleeding, or leaking from the puncture site
  • Numbness, tingling, or pain in your lower back or legs
  • Weakness in your lower legs or problems walking
  • Problems passing or controlling urine or stool
  • A stiff neck
  • Pain is not eased by medicine

If you think you have an emergency, call for medical help right away.

RESOURCES

Family Doctor—American Academy of Family Physicians  http://familydoctor.org 

National Institute of Neurological Disorders and Stroke  http://www.ninds.nih.gov 

CANADIAN RESOURCES

About Kids Health—The Hospital For Sick Children  http://www.aboutkidshealth.ca 

Health Canada  https://www.canada.ca 

References

Glimåker M, Johansson B, et al. Early lumbar puncture in adult bacterial meningitis--rationale for revised guidelines. Scand J Infect Dis. 2013 Sep;45(9):657-663.

Lumbar puncture (LP). EBSCO DynaMed website. Available at  https://www.dynamed.com/procedure/lumbar-puncture-lp  . Updated March 27, 2019. Accessed April 9, 2020.

Lumbar puncture. Radiological Society of North America Patient website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=spinaltap. Updated April 30, 2018. Accessed April 9, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 02/2020
  • Update Date: 04/10/2020