Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-11T03:32:04.716Z Has data issue: false hasContentIssue false

Chapter 4 - Lumbar Puncture

from Section 1 - Neurologic Examination and Neurodiagnostic Testing

Published online by Cambridge University Press:  10 January 2024

By
Troy Desai ,
Dan Geary ,
Chris Troianos  and
Richard Feduska
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
Get access

Summary

Lumbar puncture (LP) is a diagnostic procedure that can be performed successfully in most patients with minimal discomfort. The key factors to a successful LP are an understanding of the anatomy of the lumbar spine, careful positioning of the patient, and a thorough palpation of the bony landmarks to identify the lumbar interspaces.

Keywords

ligamentum flavumintrathecal spacepost-dural puncture headacheopening pressureanticoagulation
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 41 - 50
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Carson, D, Serpell, M. Choosing the best needle for diagnostic lumbar puncture. Neurology 1996;47:33–37.CrossRefGoogle ScholarPubMed
Chin, KJ, Karmakar, MK, Peng, P. Ultrasonography of the adult thoracic and lumbar spine for central neuraxial blockade. Anesthesiology 2011;114:1459–1485.Google Scholar
Chin, KJ, Perlas, A, Chan, V, et al. Ultrasound imaging facilitates spinal anesthesia in adults with difficult surface anatomic landmarks. Anesthesiology 2011;115:94–101.CrossRefGoogle ScholarPubMed
Ferre, RM, Sweeney, TW. Emergency physicians can easily obtain ultrasound images of anatomic landmarks relative to lumbar puncture. Am J Emerg Med 2007;25:291–296.CrossRefGoogle Scholar
Halpern, S. Postdural puncture headache and spinal needle design: metanalysis. Anesthesiology 1994;81:1376–1383.CrossRefGoogle Scholar
Horlocker, TT, Wedel, DJ, Rowlingson, JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy. Reg Anesth Pain Med 2010;35:64–101.Google Scholar
Paech, MJ, Doherty, DA, Christmas, T, et al. The volume of blood for epidural blood patch in obstetrics: a randomized, blinded clinical trial. Anesth Analg 2011;113:126–133.Google Scholar
Safa-Tissront, V, Thormann, F, Malassine, P, et al. Effectiveness of epidural blood patch in the management of post-dural puncture headache. Anesthesiology 2001;95(2):334–339.Google Scholar
Stachan, A, Train, J. Aspirating cerebrospinal fluid speeds up procedure. BMJ 1998;316:1018.Google Scholar
Wolf, S, Schneble, F, Troger, J. The conus medullaris: time of ascendence to normal level. Pediatr Radiol 1992;22:590–592.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×