How It Is Performed
For performing a lumbar puncture, the patient has to lie on their sides. The doctor or nurse will clean the area and give local anesthesia. After that, they will insert a thin needle in the lower back between two vertebrae of the spine. The procedure takes around half an hour and patients can return home an hour later if they dont have any symptoms.
What Care Is Needed After Lumbar Puncture
You need to take good care of the baby so that they can recover in the shortest time. Here are some points to remember after a lumbar puncture for an infant:
If the baby is younger than six months, then breast milk is the only source of fluids.
Spinal tap in babies does not have any long-term repercussions, and your baby can lead a normal life immediately after the procedure. Proper care is all that is needed for a speedy recovery. However, the process is not completely free of side-effects, and your baby could experience these symptoms right after the process. There are some symptoms, which warrant immediate medical attention.
Epidural Blood Patch Can Cause Acute Neurologic Deterioration
Associate Professor, Department of Anesthesiology, University of Utah Medical Center, Salt Lake City, Utah.
Attending Anesthesiologist, Primary Children’s Medical Center, Salt Lake City, Utah.
Assistant Professor, Department of Anesthesiology, University of Utah Medical Center, Salt Lake City, Utah.
Received from the Primary Children’s Medical Center and the Department of Anesthesiology, University of Utah Medical Center, Salt Lake City, Utah. Submitted for publication May 2, 1994. Accepted for publication September 1, 1994.
Address correspondence to: Richard Sperry, M.D., Department of Anesthesiology, University of Utah Medical Center, 50 North Medical Drive, Salt Lake City, Utah 84132.
Anesthesiology
Richard J. Sperry, Alan Gartrell, Joel O. Johnson Epidural Blood Patch Can Cause Acute Neurologic Deterioration. Anesthesiology 1995 82:303305 doi:
Key words: Anesthetic techniques: epidural blood patch. Complications: increased intracranial pressure postdural puncture headache.
You May Like: Advil For Lower Back Pain
Treatment Of Back Pain Months After Lumbar Puncture
Doctors generally prescribe symptomatic treatment for this type of disease, because the body heals on its own. If the organism can be identified, specific antimicrobials are prescribed to prevent further damage to the spine. If youre experiencing back pain, you can follow the steps below to get some relief:
Are There Any Risks
A lumbar puncture is generally safe and the risk of serious complications is low.
Serious side effects are uncommon, although many people experience headaches caused by CSF leaking out through the hole in the spine made by the needle. You wont see this leakage because it occurs internally, not through the skin.
The headaches are typically worse when in the upright position and can usually be relieved by lying down. Drinking plenty of fluids and taking simple pain killers will also help. It can take up to a week for the hole to heal and the fluid to stop leaking.
Read more about the possible side effects of a lumbar puncture.
Recommended Reading: Will Aleve Help Back Pain
Complications After Spinal Tap
A lumbar puncture or spinal tap may be performed for a number of reasons including diagnostic, investigative or therapeutic. It is an extremely technique-sensitive procedure that involves careful insertion of a needle between two lumbar vertebrae bones of the spine near the lower back to remove a sample of cerebrospinal fluid .
The procedure is performed with the patient in an upright position or commonly in the fetal position. A small amount of local anesthesia is injected at the site of entry to make the procedure more bearable.
What Are The Risks Of A Lumbar Puncture
Because this procedure involves the spinal cord and brain, the followingcomplications may occur:
- A small amount of CSF can leak from the needle insertion site. This can cause headaches after the procedure. If the leak continues, your headache can be severe.
- You may have a slight risk of infection because the needle breaks the skins surface, providing a possible way for bacteria to enter the body.
- Short-term numbness of the legs or lower back pain may be experienced.
- here is a risk of bleeding in the spinal canal.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
Recommended Reading: Does Motrin Help With Back Pain
Spondylodiscitis Occurring After Diagnostic Lumbar Puncture: A Case Report
Mehmet Sabri Gürbüz
1Department of Neurosurgery, Haydarpaa Numune Research and Educational Hospital, Tbbiye Caddesi, No. 40, Üsküdar, 34668 stanbul, Turkey
Academic Editor:
Abstract
Spondylodiscitis is a rare disease which is generally seen after long-term epidural catheterization. However, spondylidiscitis developing after diagnostic lumbar puncture is very rare. Early diagnosis has a crucial role in the management of the disease and inclines the morbidity rates. However, the diagnosis is often delayed due to the rarity and insidious onset of the disease usually presenting with low back pain which has a high frequency in the society. If it is diagnosed early before development of an abscess requiring surgery or neurological deficit, it responds to antimicrobial therapy quite well. We report 66-year-old male case of spondylodiscitis developing after diagnostic lumbar puncture. The patient was treated with antimicrobial therapy. After antimicrobial therapy, findings of spondylodiscitis were completely resolved and no recurrence was seen in the period of 9-month followup.
1. Introduction
2. A Case Report
Ceftazidime and vancomycin were given for 4 weeks. The blood and CSF cultures were negative. In lumbar MRI scan done after 4 weeks of ceftazidime and vancomycine treatment, signs of spondylodiscitis were persisting ), and infection markers were still high .
3. Discussion
References
Copyright
Related articles
How Is A Spinal Headache Managed Or Treated
To manage most spinal headaches, doctors recommend:
- Lying down
- Drinking lots of fluids, including drinks containing caffeine
- Taking over-the-counter pain relievers such as ibuprofen
Sometimes, these measures do not relieve the pain. If a spinal headache lasts more than a few days, your doctor may recommend a procedure called an epidural blood patch. During this procedure, the doctor injects a small amount of your own blood over the hole. When the blood clots, it seals the hole.
In very rare cases, doctors use surgery to seal the hole where spinal fluid is leaking.
You May Like: Will Naproxen Help Back Pain
When Do You Need A Spinal Tap
Spinal taps are often done to help diagnose infections of the central nervous system . One of the most common reasons for doing a lumbar puncture is for , says Jeff Gadsden, MD, FRCPC, FANZCA, Division Chief of Orthopaedic, Plastic and Regional Anesthesiology at Duke University Medical Center in Durham, North Carolina.
Well take a sample of cerebrospinal fluid, he explains, and if we see certain infectious organisms growing in it, that gives us a clue as to how to tailor our antibiotic therapy.
The procedure can also help providers:
-
Identify certain CNS disorders, such as multiple sclerosis, Guillain-Barré syndrome or epilepsy
-
Diagnose cancers affecting the brain or spinal cord
-
Administer chemotherapy or anesthesia
It can help with imaging, as well. A provider may inject contrast agents into the CSF if theyre trying to get an anatomic view of the spinal cord and the coverings of the spinal cord, Dr. Gadsden says. It’s particularly helpful when a patient can’t undergo an MRI.
A spinal tap can be done in a hospital or outpatient facility, depending on why its needed. Its not an emergency procedure. We think about emergencies, that brings to mind the sort of things that have to be done within seconds to minutes, and thats never the case for a lumbar puncture, Dr. Gadsden explains. I would characterize it more as an urgent proceduresomething that we would want to do in the timeframe of hours rather than minutes.
Why Are Spinal Taps Done
The central nervous system is made up of the brain and spinal cord. It’s the “command center” for the body. The spinal cord sends signals to and from the brain, and the brain interprets them. Cerebrospinal fluid constantly flows around the central nervous system while protecting it.
A CSF sample can provide a lot of important information about a person’s health. So a spinal tap can help doctors find or rule out many diseases or conditions.
Most often, doctors order a spinal tap to see if a child has meningitis . A spinal tap also can help them look for other conditions that affect the nervous system.
Spinal taps also can be used to add medicine, anesthesia, or dye directly into the cerebrospinal fluid. Occasionally, they’re done to help relieve pressure in the brain when a condition causes the body to make too much CSF.
Read Also: Aleve Or Ibuprofen For Back Pain
Why Might I Need A Lumbar Puncture
A lumbar puncture may be done for variousreasons. The most common reason is to remove a small amount of CSF for testing.This can help in the diagnosis of various disorders. The fluid is tested forred and white blood cells, protein, and glucose . The clarity and colorof the fluid are also checked and it is tested to see whether bacteria,viruses, or abnormal cells are present. Excess CSF may also be removed inpeople who have an overproduction or decreased absorption of the fluid.
A lumbar puncture procedure may be helpfulin diagnosing many diseases and disorders, including:
In addition, a lumbar puncture may be usedto measure the pressure of the CSF. The healthcare provider uses a special tube to measures the pressure during a lumbar puncture.
Finally, a lumbar puncture may be done toinject medicine directly into the spinal cord. These include:
- Spinal anesthetics before a surgical procedure
- Contrast dye for X-ray studies – for example, myelography
- Chemotherapy drugs used to treat cancer
Your healthcare provider may have otherreasons to recommend a lumbar puncture.
Pseudotumor Cerebri | Ashley’s Story
After visiting 30+ physicians, Ashley was diagnosed with the rare condition known as pseudotumor cerebri. She and her family turned to the experts at Johns Hopkins who worked as a team to implant a stent, a new approach to treating this condition that is typically treated with a shunt.
Lumbar Puncture: Testing For Meningitis
Confirming the diagnosis
A lumbar puncture is the most common method of obtaining a sample of the fluid in the spinal canal for examination. The evaluation of the spinal fluid is usually necessary for the definitive diagnosis and to help make optimal treatment decisions .
The diagnosis is confirmed by abnormal spinal fluid results and, in the case of an infection, by identifying the organism causing the infection. In patients with meningitis, the CSF fluid often has a low glucose level and increased white blood cell count.
Normal values for spinal fluid examination are as follows:
- Protein
- Cell count
- Initial pressure
These normal values can be altered by injury or disease of the brain, spinal cord, or adjacent tissues. The values are routinely evaluated during examination of the spinal fluid obtained from the lumbar puncture. Additionally, spinal fluid is tested for infection in the microbiology laboratory.
A health care professional will usually review and interpret the test results with the patient. These results often will need to be evaluated in relation to other blood and radiologic test results.
Don’t Miss: Does Aleve Help Back Pain
Surgical Removal Of Hemangioma
Surgical removal of the tumor is a potential treatment option for a vertebral hemangioma. The extent of spinal surgery, also called surgical resection, depends upon the size of the hemangioma, according to Indiana University-Purdue University Indianapolis. Large hemangiomas may require a surgeon to also remove portions of the affected vertebra during surgery. Removing the spinal tumor decreases the amount of pressure placed on the spinal cord, which diminishes or eliminates back pain or discomfort. Spinal surgery is a major procedure and can result in certain complications, such as spinal cord injury, blood clots or infection, the University of Maryland Medical Center reports. Patients should discuss the risks of this form of vertebral hemangioma treatment with a physician prior to surgery.
- Surgical removal of the tumor is a potential treatment option for a vertebral hemangioma.
- Spinal surgery is a major procedure and can result in certain complications, such as spinal cord injury, blood clots or infection, the University of Maryland Medical Center reports.
Back Pain Following Spinal Anesthesia: Busting The Myth
Make an Appointment
Low back ache is one of the most common reasons for absenteeism as it causes frequent visits to the physician, both for backache and for the emotional component associated with the unresolving pain.
Spinal anaesthesia has been commonly linked to low back aches especially in patients who have had a caesarean section. There is a cloud of misconception and anxiety that forms a major cause for patients refusing a spinal anesthetic when it is an appropriate mode of anaesthesia. Interestingly, a search has revealed that general anesthetics carry a similar propensity to cause backaches.
Reasons for Back pain in Spinal anaesthesia
Analysing the reasons, there can be a number of mechanisms for the development of back pain in patients who have received an anesthetic via general or spinal anaesthetic route. It could be related to the surgery itself, the surgical position, the duration of surgery to name a few. Specifically for spinal anaesthetics, the potential reason could lie in the type of needle used, unintentional injection of saline or local anesthetic into the tissues, the development of a blood collection due to tissue trauma to the muscles and soft tissues and perhaps overstretching of the muscles after the desired relaxation has been achieved.
Benefits of Spinal Anaesthesia
Careful assessment, explanation, risk benefit discussion and reassurance preoperatively by the anaesthetist will go a long way in building trust and gaining the patients confidence.
You May Like: Is Advil Good For Back Pain
When Should I Call The Doctor
Spinal headaches typically go away in a few days. Over-the-counter pain medicines, staying hydrated, and drinking caffeinated beverage scan help. You should call your healthcare provider if the headache is extremely painful and lasts more than a few days, or you experience:
- Bloody discharge or drainage at the puncture site.
- Signs of infection, such as fever.
A note from Cleveland Clinic
A procedure that involves the spine may sound scary, but spinal taps carry little risk. Talk to your healthcare provider about any concerns. If you develop a spinal headache after the procedure, your provider can offer suggestions to ease the pain.
Can A Spinal Tap Heal On Its Own
In rare cases, a spinal tap can lead to long-term damage. Spinal taps cause nerve damage in less than 1 in 1000 cases, so its a pretty rare side effect. When nerve damage occurs, the nerves usually heal on their own within a few days, weeks, or months. In extremely rare cases, permanent nerve damage may result in paralysis.
You May Like: Will Aleve Help With Back Pain
What Is The Cerebrospinal Fluid
The CSF circulates around the brain and spinal cord . This “water bath” acts as a support of buoyancy for the brain and spinal cord. The support of the CSF helps to protect the brain from injury.
The normal CSF appears clear and contains various substances, such as protein and sugar , and few if any cells. The spinal fluid also has a normal pressure when first removed.
What Is A Spinal Headache
A spinal headache is a very intense headache. It occurs when cerebrospinal fluid leaks out of the meninges .
This leakage reduces the amount of fluid around the brain. The leakage can cause the tissues and nerves that support the brain to stretch painfully.
Spinal headaches typically last from a few hours to a few days. These headaches feel better when a person is lying down and get worse when sitting up or standing. They are also known as post-dural puncture headaches and epidural headaches.
You May Like: How Much Advil Can I Take For Back Pain
Take Time To Rest Afterward
Afterwards, I laid on my back in the hospital for a couple hours while they observed me . I actually felt pretty great afterwards though, which led me to make a big mistake. I was in college and itching to get back to playing hockey. So I rested immediately after my spinal tap but decided to go play in a hockey game that night. That turned out to be a massive mistake on my part. One of the big reasons for resting after a spinal tap is so that no cerebrospinal fluid leaks from the puncture site.
What Causes A Spinal Headache
The most common cause of a spinal headache is a puncture created during a procedure called a spinal tap or lumbar puncture. Doctors use this procedure to diagnose illness and deliver anesthesia, such as when pregnant women have an epidural during childbirth.
Area of lower spine where spinal tap is taken and close-up of needle in the spinal canal.
During the lumbar puncture, a doctor inserts a needle into the spinal canal in the lower back to deliver anesthesia or withdraw a sample of cerebrospinal spinal fluid. Sometimes, spinal fluid leaks out of the tiny hole created by the needle. The loss of fluid reduces the fluid balance surrounding the brain, which causes the brain to sag downward. The surrounding nerves and tissues become stretched, which results in the headache.
Other conditions can cause spinal fluid leaks that lead to spinal headaches. These problems include a ruptured cyst on the spinal cord and a head or face injury such as a fractured skull.
You May Like: Tylenol Or Aleve For Back Pain
