Lumbar Puncture

What you should know

• Lumbar puncture, also called LP, is a procedure where a needle is inserted in your back and into the spinal canal. This is done to collect cerebrospinal fluid (CSF) or treat certain medical conditions. The spinal canal contains the spinal cord, which carries messages between your brain and your body, and CSF. CSF is a clear fluid that flows around the brain and inside the spinal canal. This fluid contains information about body functions and disease processes. It also acts as a cushion to protect the brain and spinal cord from injury. LP may be used to check for an infection, inflammation (swelling), or other conditions affecting the brain. You cannot have an LP if you have increased pressure in the brain. This increased pressure may be caused by a tumor or blockage. If you bleed easily or an infection is present in the area where the needle will be inserted, a LP will not be done.
  
  
• During a lumbar puncture, CSF may be collected and sent to a lab for tests. The tests check for changes in the CSF, including the presence of blood, protein, glucose (sugar), and germs. The sample may also be used to do certain tests that check for an infection. Sometimes, medicine may be put through the LP into your back to treat a disease. CSF pressure may also be measured during LP.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

Having a lumbar puncture may put you at risk of having other problems. You may have a headache that gets worse when you sit or stand. You may also have neck or back pain. There may be bleeding, infection, injury to a disk in your spine, or spinal fluid may leak from the site. Your nerves or spinal cord may be damaged. Medicines, including anesthesia, that are used during the procedure may cause an allergy. Patients who have blood disorders or who are taking certain medicines are at a higher risk for problems. LP may not be advised for those who are vomiting, have a bad headache, or have problems staying awake. Talk with your caregiver if you are worried or have questions about your procedure, medicine, or care.

Getting Ready

Before your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Tell your caregiver if you are taking any medicine that may make you more likely to bleed. These medicines may include aspirin, clot busters, or blood thinners. If you are taking any of these medicines, you should not have a lumbar puncture.
  
  
• Tell your caregiver if you have any allergies. This includes an allergy to a cleansing solution, such as iodine, or any numbing medicine.
  
  
• Tell your caregiver if you have a blood disorder or have had a bleeding problem in the past.
  
  
• Tell your caregiver if you know or think you might be pregnant.
  
  
• Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.
  
  
• You may need to have blood tests, x-rays, or other tests. Brain imaging tests, such as computerized tomography (CT) scan or magnetic resonance imaging (MRI) may also be done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the procedure. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Treatment

What will happen:

• You will be asked to change into a hospital gown. You will be asked to lie on your side, or to sit up. If you will be lying on your side, your knees will need to be bent and drawn close to your chest. Your neck should also be tucked toward your chest. If you are sitting, you will need to bend forward with your neck tucked toward your chest. You may be given medicine to help you relax or make you drowsy.
  
  
• Your caregiver will find the best place to do the LP, and mark the place using a marker. Your lower back will be cleaned, and you may be given one or more shots of numbing medicine. A needle will be inserted between the vertebrae (spine) of the lower back. You may feel some pushing or discomfort as the needle enters your back. Tell your caregiver if you have pain that does not stop within a few seconds. Your caregiver may need to pull out, reinsert, or change the position of the needle to find the spinal canal.
  
  
• Your caregiver may take readings of your CSF pressure. This will be done by connecting a measuring device to the needle. After the pressure is measured, the device will be removed to allow CSF to flow out of the needle. Samples of your CSF may be taken. The needle will then be taken out and a bandage secured over the area.

After your procedure:

You will need to lie flat in bed for a time that may be between 1 and 24 hours. When caregivers see that you are OK, you may be allowed to go home. If caregivers want you to stay in the hospital, you will be taken back to your hospital room. You may need to drink more liquids than usual after the LP, or you may need fluids through the vein (IV).

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your procedure appointment on time.
  
  
• You have a skin infection or a wound near the area where the LP will be done.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your procedure.

Seek Care Immediately if

• You have a fever.
  
  
• You have trouble breathing or your heart is beating faster than normal.
  
  
• Your signs and symptoms are getting worse.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.