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Diagnostic & Therapeutic

Lumbar Puncture
(Spinal Tap)

A procedure in which a needle is inserted into the spinal canal to collect cerebrospinal fluid (CSF) for analysis.

Lumbar Puncture Procedure

Duration

15-30 minutes

Discomfort

Mild discomfort or pressure sensation during needle insertion; local anesthetic minimizes pain

Description

A lumbar puncture (spinal tap) is a procedure in which a needle is inserted into the spinal canal to collect cerebrospinal fluid (CSF) for analysis. CSF surrounds the brain and spinal cord and can provide important diagnostic information.

Purpose & Uses

Diagnosis of meningitis (bacterial, viral, fungal)
Diagnosis of encephalitis
Detection of subarachnoid hemorrhage
Diagnosis of multiple sclerosis (MS)
Investigation of central nervous system infections
Measurement of intracranial pressure
Therapeutic removal of CSF (in hydrocephalus)
Administration of medications (chemotherapy, antibiotics)

Procedure Steps

1

Patient lies on side in fetal position (or sits bent forward)

2

Back is cleaned with antiseptic solution

3

Local anesthetic is injected

4

Needle is carefully inserted between vertebrae into spinal canal

5

Cerebrospinal fluid is collected in sterile tubes

6

Needle is withdrawn

7

Bandage is applied to puncture site

CSF Analysis

  • Cell count and differential
  • Protein and glucose levels
  • Gram stain and culture
  • Viral or fungal testing
  • Oligoclonal bands (for MS)

Results

Normal CSF

Clear, acellular, normal protein and glucose

Abnormal CSF

May show elevated white blood cells, elevated protein, low glucose, positive cultures, or other abnormalities

Risks (rare)

  • Infection
  • Bleeding
  • Nerve damage
  • Post-lumbar puncture headache (occurs in 10-25% of patients)

Preparation

  • Inform physician of bleeding disorders or anticoagulant use
  • Fasting may be required
  • Empty bladder before procedure
  • Wear loose, comfortable clothing
  • Arrange transportation (patient should not drive after procedure)

Post-Procedure Care

  • Rest for several hours
  • Drink plenty of fluids
  • Lie flat for 30 minutes if post-LP headache develops
  • Avoid strenuous activity for 24 hours
  • Report severe headache, fever, or neurological symptoms

Related Conditions

Meningitis Encephalitis MS Subarachnoid hemorrhage

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