Spinal puncture: Difference between revisions
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A '''spinal puncture''', also called a '''spinal tap''', '''lumbar puncture''', or '''LP''' is "tapping of the subarachnoid space in the lumbar region, usually between the third and fourth lumbar [[vertebra]]e.<ref>{{MeSH}}</ref><ref name="pmid17062865">{{cite journal |author=Straus SE, Thorpe KE, Holroyd-Leduc J |title=How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis? |journal=JAMA |volume=296 |issue=16 |pages=2012–22 |year=2006 |month=October |pmid=17062865 |doi=10.1001/jama.296.16.2012 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=17062865 |issn=}}</ref><ref name="pmid17005943">{{cite journal |author=Ellenby MS, Tegtmeyer K, Lai S, Braner DA |title=Videos in clinical medicine. Lumbar puncture |journal=N. Engl. J. Med. |volume=355 |issue=13 |pages=e12 |year=2006 |month=September |pmid=17005943 |doi=10.1056/NEJMvcm054952 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=17005943 |issn=}}</ref> | A '''spinal puncture''', also called a '''spinal tap''', '''lumbar puncture''', or '''LP''' is "tapping of the subarachnoid space in the lumbar region, usually between the third and fourth lumbar [[vertebra]]e.<ref>{{MeSH}}</ref><ref name="pmid17062865">{{cite journal |author=Straus SE, Thorpe KE, Holroyd-Leduc J |title=How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis? |journal=JAMA |volume=296 |issue=16 |pages=2012–22 |year=2006 |month=October |pmid=17062865 |doi=10.1001/jama.296.16.2012 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=17062865 |issn=}}</ref><ref name="pmid17005943">{{cite journal |author=Ellenby MS, Tegtmeyer K, Lai S, Braner DA |title=Videos in clinical medicine. Lumbar puncture |journal=N. Engl. J. Med. |volume=355 |issue=13 |pages=e12 |year=2006 |month=September |pmid=17005943 |doi=10.1056/NEJMvcm054952 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=17005943 |issn=}}</ref><ref name="pmid3518565">{{cite journal| author=Marton KI, Gean AD| title=The spinal tap: a new look at an old test. | journal=Ann Intern Med | year= 1986 | volume= 104 | issue= 6 | pages= 840-8 | pmid=3518565 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3518565 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
==Procedure== | ==Procedure== | ||
Use of an 'atraumatic needle' may reduce the chance of [[headache]], although this needle is more difficult to use and may increase the number attempts needed before successful puncture.<ref name="pmid17062865"/> Reinsertion of the stylet before needle removal decreases headache.<ref name="pmid17062865"/> | Use of an 'atraumatic needle' may reduce the chance of [[headache]], although this needle is more difficult to use and may increase the number attempts needed before successful puncture.<ref name="pmid17062865"/> Reinsertion of the stylet before needle removal decreases headache.<ref name="pmid17062865"/> | ||
To accurately measure the opening pressure of the cerebrospinal fluid: | |||
* The patient should be laying (not sitting)<ref>Loman J, Myerson A, Goldman D. Effects of alterations in posture on the cerebrospinal fluid pressure. Arch Neurol Psych. 1934:1279-1295. **/ref><ref name="pmid1271089">{{cite journal| author=Magnaes B| title=Body position and cerebrospinal fluid pressure. Part 1: clinical studies on the effect of rapid postural changes. | journal=J Neurosurg | year= 1976 | volume= 44 | issue= 6 | pages= 687-97 | pmid=1271089 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1271089 | doi=10.3171/jns.1976.44.6.0687 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/-->**</ref><ref name="pmid1271090">{{cite journal| author=Magnaes B| title=Body position and cerebrospinal fluid pressure. Part 2: clinical studies on orthostatic pressure and the hydrostatic indifferent point. | journal=J Neurosurg | year= 1976 | volume= 44 | issue= 6 | pages= 698-705 | pmid=1271090 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1271090 | doi=10.3171/jns.1976.44.6.0698 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
* The patient's neck should be relaxed to prevent Queckenstedt's test which can raise pressure by 10-20 cm<ref name="pmid5005427">{{cite journal| author=Deliyannakis E| title=Influence of the position of the head on the cerebrospinal fluid pressure. Variations of the Queckenstedt sign. | journal=Mil Med | year= 1971 | volume= 136 | issue= 4 | pages= 370-2 | pmid=5005427 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=5005427 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/-->**</ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 06:26, 19 October 2009
A spinal puncture, also called a spinal tap, lumbar puncture, or LP is "tapping of the subarachnoid space in the lumbar region, usually between the third and fourth lumbar vertebrae.[1][2][3][4]
Procedure
Use of an 'atraumatic needle' may reduce the chance of headache, although this needle is more difficult to use and may increase the number attempts needed before successful puncture.[2] Reinsertion of the stylet before needle removal decreases headache.[2]
To accurately measure the opening pressure of the cerebrospinal fluid:
- The patient should be laying (not sitting)Cite error: Closing
</ref>missing for<ref>tag[5] - The patient's neck should be relaxed to prevent Queckenstedt's test which can raise pressure by 10-20 cm[6]
References
- ↑ Anonymous (2024), Spinal puncture (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 2.2 Straus SE, Thorpe KE, Holroyd-Leduc J (October 2006). "How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis?". JAMA 296 (16): 2012–22. DOI:10.1001/jama.296.16.2012. PMID 17062865. Research Blogging.
- ↑ Ellenby MS, Tegtmeyer K, Lai S, Braner DA (September 2006). "Videos in clinical medicine. Lumbar puncture". N. Engl. J. Med. 355 (13): e12. DOI:10.1056/NEJMvcm054952. PMID 17005943. Research Blogging.
- ↑ Marton KI, Gean AD (1986). "The spinal tap: a new look at an old test.". Ann Intern Med 104 (6): 840-8. PMID 3518565.
- ↑ Magnaes B (1976). "Body position and cerebrospinal fluid pressure. Part 2: clinical studies on orthostatic pressure and the hydrostatic indifferent point.". J Neurosurg 44 (6): 698-705. DOI:10.3171/jns.1976.44.6.0698. PMID 1271090. Research Blogging.
- ↑ Deliyannakis E (1971). "Influence of the position of the head on the cerebrospinal fluid pressure. Variations of the Queckenstedt sign.". Mil Med 136 (4): 370-2. PMID 5005427. **