A doctor and at least one assistant will be in the room. You will lie on your side with your knees drawn to your chest so that your spine is curved; in some cases you may sit on the table and lean forward onto some pillows instead. After cleaning your back with a cooling antiseptic, the doctor will numb the area of your lower back where the needle will be inserted.
This may cause some brief stinging. Step 2: insert the needle Next, a hollow needle is inserted between the third and fourth lumbar vertebrae into your spinal canal Fig. The needle doesn't touch the nerves of your spinal cord. Your doctor will collect between 5 to 20 ml of cerebrospinal fluid in 2 to 4 tubes. You will probably feel pressure when the needle is inserted, and some people feel a sharp stinging sensation when the needle goes through the protective dural layer that surrounds the spinal cord.
Although you may feel some discomfort, it is important that you lie still. Let your doctor know if you are feeling pain. Step 3: measure CSF pressure optional You will be asked to straighten your legs to decrease abdominal pressure and increase cerebrospinal fluid pressure.
The needle is attached to a meter and the pressure in your spinal canal is measured. Step 4: insert a lumbar drain optional In cases of hydrocephalus, a catheter may be inserted to continuously remove CSF and relieve pressure on the brain. The doctor will apply pressure to the puncture site, then apply a bandage. The healthcare provider uses a special tube called a manometer to measure s the pressure during a lumbar puncture.
Finally, a lumbar puncture may be done to inject medicine directly into the spinal cord. These include:. Your healthcare provider may have other reasons to recommend a lumbar puncture. Because this procedure involves the spinal cord and brain, the following complications may occur:.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure. I f you are having a lumbar puncture at Johns Hopkins Hospital or Bayview Medical Center, a neuroradiologist or radiology nurse will contact you by phone two or three days prior to your lumbar puncture to discuss the procedure and answer any questions you may have.
Please inform the neuroradiology physician if:. Other options should be discussed with you and your doctor. A gown will be provided for you.
However, the procedure may also be done while you remain in your clothes from home. For this reason, try to wear non-restrictive, comfortable clothing and slip on shoes if possible. Please remove all piercings and leave all jewelry and valuables at home. If you are not sure if it is safe for you, contact your primary care provider or referring provider. However, on the day of the procedure, do not eat for three hours before the procedure.
You may have liquids and can take your usual medications unless previously advised to hold certain medications in preparation for the lumbar puncture. Please bring a current list of your medications and allergies with you. This is for your safety and comfort. A lumbar puncture procedure may be done on an outpatient basis or as part of your stay in a hospital.
Procedures may vary depending on your condition and your doctor's practices. Some healthcare providers may prefer to do this procedure at the bedside or may opt to have it done using a type of live X-ray called fluoroscopic guidance. You may have discomfort during a lumbar puncture. Your healthcare providers will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain. This helps reduce the incidence of a headache.
You will be allowed to roll from side to side as long as your head is not elevated. If you need to urinate, you may need to do so in a bedpan or urinal during the time that you need to stay flat.
Your doctor may also recommend a CT scan or MRI to determine if you have any abnormal swelling in or around your brain. Your health care professional will give you specific instructions about food, drink and medications. Tell your doctor or nurse if you're taking blood-thinning or other anticoagulant medications. Examples include warfarin Coumadin, Jantoven , clopidogrel Plavix , and some over-the-counter pain relievers such as aspirin, ibuprofen Advil, Motrin IB, others or naproxen sodium Aleve.
Also, tell your doctor or nurse if you're allergic to any medications, such as numbing medications local anesthetics. A lumbar puncture is usually done in an outpatient facility or a hospital by a doctor or a nurse.
Your doctor or nurse will talk to you about the potential risks, and any discomfort you might feel during the procedure. If a child is having a lumbar puncture, a parent may be allowed to stay in the room in some cases. Talk to your child's doctor or nurse about whether this will be possible. You may be asked to change into a hospital gown, although in some cases you may have the procedure while wearing your own clothing.
There are a few possible positions for this test. Usually, you lie on your side with your knees drawn up to your chest, or you sit and lean forward on a stable surface. These positions flex your back, widening the spaces between your vertebrae and making it easier for your doctor to insert the needle. The procedure usually lasts about 45 minutes.
Your doctor or nurse may suggest lying down after the procedure. Sometimes, an ultrasound may be used as a guide during the procedure on infants and young children. The ultrasound can help prevent inserting the needle too far. Back to Health A to Z. A lumbar puncture is where a thin needle is inserted between the bones in your lower spine.
It should not be painful, but you may have a headache and some back pain for a few days. Your doctor or nurse should explain what's going to happen and why you need a lumbar puncture.
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