What you need to know about:

Lumbar Puncture

Fast Fact

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Recovery Period:
4 hours in hospital
Permanence:
Not specified
177
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Time it takes:
45 minutes
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Anesthetize:
Local Anesthesia

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Overview of

Lumbar Puncture

in Thailand

A lumbar puncture (spinal tap) is an invasive medical procedure where a needle is inserted into the spinal canal (subarachnoid space) to remove cerebrospinal fluid (CSF) for analysis, to inject medication into the subarachnoid space to alleviate pain, or to inject other medication to treat diseases of the meninges, such as to deliver chemotherapy for cancer that has metastasized to the meninges. Cerebrospinal fluid is a liquid in the subarachnoid space that stabilizes the brain and spinal cord and keeps them from moving. Any abnormalities of the meninges, spinal cord, and/or brain can affect the cerebrospinal fluid. That is why removing cerebrospinal fluid for examination is important if abnormalities of the meninges and/or spinal cord is suspected.

Goals of

Lumbar Puncture

A lumbar puncture can be used for:  -Removing cerebrospinal fluid due to hydrocephalus can reduce pressure in the skull -Administering intratechal injection to treat cancer that has metastasized to the meninges -Adminstering anesthesia to reduce pain during certain surgeries -For diagnosis of disease, such as meningitis or inflammation of the spinal cord and/or nerves

Price of

Lumbar Puncture

Average Cost

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Pros and cons of

Lumbar Puncture

Pros

-Can help diagnose and exclude important medical conditions to help formulate the management plan which include:  

Serious bacterial, fungal and viral infections, including meningitis, encephalitis and syphilis

Bleeding around the brain (subarachnoid hemorrhage)

Certain cancers involving the brain or spinal cord

Certain inflammatory conditions of the nervous system, such as multiple sclerosis and Guillain-Barre syndrome  

Cons

-Can be a painful for certain individuals  

-You may have a headache and some back pain for a few days.  

-Associated risks and complications are not common but possible, these are:

- Bleeding. Bleeding may occur near the puncture site or, rarely, into the epidural space.

- Brainstem herniation. Increased pressure within the skull (intracranial), due to a brain tumor or other space-occupying lesion, can lead to compression of the brainstem after a sample of cerebrospinal fluid is removed.

How It Works:

Lumbar Puncture

You will either lie on your side with your knees drawn as close to your chest as possible and your chin toward your chest or sit with your arms and head resting on a table. After cleaning your back with an antiseptic, sterile cloths (called drapes) will be placed around the area. A local anesthetic (pain-relieving medication) will be injected into the area on your back. You may feel a slight burning sensation. When the area becomes numb, a hollow needle will be inserted in the lower back between two lumbar vertebrae. This sometimes causes a feeling of pressure. The spinal canal will be penetrated and fluid will be collected or medication will be injected. The spinal cord will not be touched by the needle during the test. You may feel some discomfort or have a minor headache. The needle will be removed after the medication has been injected or fluid has been removed. The area will be covered with a small bandage. A blood sample will be taken from a vein in your arm and tested along with the spinal fluid in the lab. If the procedure is done to inject medication, a blood sample may not be taken.

Preparation before

Lumbar Puncture

Pre - treatment

Maintain your regular eating schedule. There are no dietary or fluid restrictions before the test. Ask your doctor for specific guidelines about discontinuing alcohol use, aspirin products, and blood-thinning drugs before the procedure. Tell your doctor if you are allergic to latex or any medications. Please make arrangements for transportation, as you should not drive immediately after the test.

Recovery after

Lumbar Puncture

Post - treatment

Once a spinal tap is completed, you will be instructed to lie flat (the time spent flat after the tap will vary depending on why you received the procedure). A nurse will discuss post-procedure instructions with you and provide the instructions to you in written form. Avoid strenuous or vigorous exercise for a day or so following the lumbar puncture. If you have a headache, lie down as much as possible and drink plenty of fluids. Contact your health care provider if the headache persists. Drink 2 1/2 quarts of liquid the day of the spinal tap and the day after (regardless of headache).

Risks & side effects

Approximately 10% to 20% of people develop a spinal headache (one that worsens when sitting or standing).  The risk of infection is extremely low. Occasionally, a small blood vessel is pierced, causing bloody discharge. No treatment is needed. The procedure is usually not painful, but momentary twinges of pain may be felt if the needle brushes against nerve tissue.

FAQs:

Lumbar Puncture

When should I consider contacting the doctor after my spinal tap?

Call your local doctor immediately if after a spinal tap: You notice any unusual drainage, including bloody discharge, at the puncture site You develop a fever Your headache persists Your pain symptoms worsen

Is a lumbar puncture painful?

Some people may experience some pain when the doctor inserts a thin needle through the skin in the lower part of your spine. This should not be painful, but you may feel some pressure.

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M.D.
Daw Aye Myat Nyein
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Ketchai Suavansri
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Mallika Techolarn
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Butree Chalanupap
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