What is a lumbar puncture?

A lumbar puncture (spinal tap) is a medical procedure that may include obtaining a sample of cerebrospinal fluid (CSF). CSF is the fluid surrounding your spinal cord and brain. This can be sent to a laboratory for testing for evidence of specific medical conditions and infections.

Why is a lumbar puncture performed?

There are several reasons you may require a lumbar puncture.

A lumbar puncture may be used to:

• Check if symptoms you're experiencing are due to a brain or spine condition
• Treat a condition, for example an infection or some types of cancer
• Give you an anaesthetic

You are usually referred by a consultant or specialist for a lumbar puncture. In some cases it is performed if you are very ill in hospital or require an emergency anaesthetic.

How do I prepare for a lumbar puncture?

If your doctor orders a lumbar puncture, they may instruct you to do the following, in addition to a physical exam and more health history, before your test:

• Get a CT scan or MRI.
• Get blood tests.
• If you use blood thinners such as warfarin or aspirin, refrain from stopping or altering your medication timetable. Do not alter your medication regimen without the approval of your doctor.

These preparations help your doctor learn more about the part of your body they will view during the procedure, ensure its safety, and take precautionary measures against complications.

Your doctor will give you specific or additional instructions to prepare for the procedure.

What happens during a lumbar puncture?

A lumbar puncture is typically performed in a hospital. It takes around 15-20 minutes, but can take longer.

Before your lumbar puncture, you will be asked to undress behind a screen and put on a hospital gown.

You may be asked to sit forward with your head and shoulders bent, or lie on your side with your knees hunched up to your chest.

A local anaesthetic will be injected into your lower back. This will make you feel nothing whilst the procedure is carried out, although you will be awake. Children are also normally given medication (a sedative) to help them relax and remain still.

The process is to slowly insert a long, thin needle through your lower back, between the bones in your spine (vertebrae). You might feel some pressure and discomfort on your back. You may also feel the sensation of pins and needles for a few seconds.

If you have tests or some treatments, fluid from your spine (cerebrospinal fluid) is withdrawn through a needle placed in several small tubes. You will have this analyzed in a laboratory. If you receive drugs or anesthesia, these are administered directly into your spine through the needle.

Once you have completed the lumbar puncture, the needle is withdrawn. A dressing on your back will cover the needle hole and control bleeding.

What should I expect after a lumbar puncture?

Following a lumbar puncture, your healthcare professional will guide you on how to care for yourself. After the procedure, you might experience some of the following:

• That you not drive or engage in heavy machinery work for 24 hours.
• Lying flat on your back or side for a couple of hours up to several hours.
• Sheltering from intense activities or exercises for 24 to 48 hours.
• Getting plenty of rest.
• Need to drink as much fluid as possible to avoid dehydration.

With your doctor's approval, you might be able to go back to work following a spinal tap.

What are the benefits of lumbar puncture?

A lumbar puncture can aid your doctor in the diagnosis or exclusion of several diseases, some of them potentially lethal. The sooner the diagnosis is issued, the sooner you can start your treatment options. Certain conditions, such as bacterial meningitis, are fatal if not treated promptly.

A spinal tap procedure also can enable your doctor to give you some types of medication.

What are the complications of lumbar puncture?

Side effects following lumbar puncture are uncommon and may include:

• Infection.
• Swelling.
• Bleeding
• Backache in the lower back.

Since your spinal cord is located above the area where the lumbar puncture is done, there is no chance that the procedure can cause damage to your spinal cord.

What is the outcome of a lumbar puncture?

A lab examines the cerebrospinal fluid sample taken after a lumbar puncture for:

• Presence of bacteria, fungi or abnormal cells.
• Blood sugar Glucose.
• Protein types and concentration.
• Types and count of white blood cells.

All these results help the medical professional to eliminate or confirm suspected conditions.

When to contact my doctor?

Call your doctor if you notice:

• An extremely painful headache that lasts for more than several days.
• Bloody drainage or discharge at the puncture site.
• Increased swelling with a fever, signifying infection.

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