Today our topic of discussion is Lumbar Puncture.
Lumbar Puncture
LUMBAR PUNCTURE
Lumbar puncture is the insertion of a needle into the subarachnoid space of the spinal canal to withdraw cerebrospinal fluid (28.7). Lumbar puncture or spinal tap or spinal puncture is the insertion of a needle into the lumbar region of the spine for removal of cerebrospinal fluid. Lumbar puncture is an aspiration of cerebrospinal fluid (CSF) from the subarachnoid space (lumbar cistern) by
Purpose
- To test the pressure of CSF
- To relieve pressure by removing CSF
- To remove fluids such as CSF, blood, pus, etc. contained in the subarachnoid space, thereby reduce the intracranial pressure
- To remove a sample of CSF for laboratory examination
- in order to diagnose disease
- To inject a spinal anesthetic, dye or air into the spinal cord
- To detect spinal subarachnoid block
- To introduce medication into the spinal fluid in treating neurological illness, e.g. meningitis.
Indications
- Diagnostic: To obtain pressure, suspected intracranial infections, suspected subarachnoid hemorrhage, peripheral none diseases (Guillain-Barré syndrome) and peripheral vascular diseases.
- Therapeutic: Intrathecal drug administrations-Inj hydrocortisone 50-100 mg in spinal arachnoiditis tuberculous meningitis to prevent late fibrotic strictures Inj. crystalline penicillin in pyogenic meningitis. Inj. methotrexate in acute lymphatic leukemic (NS) prophylaxis
- Anesthetic: Inj. lignocaine 50 mg and inj. Bupivacaine 1% in spinal anesthesia.
Contraindications
- Gross spinal tension with obvious neurological damage because of danger of complete transverse lesion Sepsis in skin at or near the proposed puncture site or osteomyelitis
- Papilledema or other signs of raised intracranial pressure or focal neurological signs, until intracranial mass is ruled out
- Bleeding diathesis or anticoagulant therapy.