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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.

Summary

Key Learning Points

1. A lumbar puncture (LP) is a useful and extremely valuable investigation and should always be considered early.
2. LPs carry a morbidity risk, and patients should be screened for contraindications before performing the procedure.
3. Performing an LP in the sitting-up position is likely to be easier than in the lateral position; however, it does prevent all the tests from being done and may not be as well tolerated by the patient (particularly the acutely meningitic patient).
4. The risk of post-dural puncture headache can be minimised by using the smallest possible ‘non-cutting’ needle.
5. Ensure to send all samples that may be required and do not forget a paired serum glucose.

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Chapter 4 - Lumbar Puncture

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5.3.1 - Principles of Performing a Lumbar Puncture (Intradural/‘Spinal’)

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Chapter 4 - Lumbar Puncture

Summary

5.3.1 - Principles of Performing a Lumbar Puncture (Intradural/‘Spinal’)

Summary