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Illustration depicting lumbar puncture (spinal tap) Spinal needles used in lumbar puncture Illustration depicting common positions for lumbar puncture procedure. The person is usually placed on their side (left more commonly than right). The patient bends the neck so the chin is close to the chest, hunches the back, and brings knees toward the ...
An epidural blood patch (EBP) is a surgical procedure that uses autologous blood, meaning the patient's own blood, in order to close one or many holes in the dura mater of the spinal cord, which occurred as a complication of a lumbar puncture or epidural placement. [1] [2] The punctured dura causes cerebrospinal fluid leak (CSF leak). [1]
Quincke's puncture" is a somewhat outdated eponym for lumbar puncture, [4] [5] used for the examination of the cerebrospinal fluid in numerous diseases such as meningitis and multiple sclerosis. In 1893 he described what is now known as idiopathic intracranial hypertension, which he labeled "serous meningitis". [6]
This procedure is to look for the level of spinal cord disease such as lumbar nerve root compression, cauda equina syndrome, conus medullaris lesions, and spinal stenosis. This is done for those who are unwilling or unable to do MRI scan of the spine. Lumbar puncture is done before injected contrast into the thecal sac.
Ultrasound-guided lumbar puncture is a medical procedure used in some emergency departments to obtain cerebrospinal fluid for diagnostic purposes. In contrast to standard lumbar puncture by palpation , the use of ultrasound imaging may reduce the number of failed punctures, needle insertions, and needle redirections. [ 1 ]
This procedure is usually performed when decompression of more than one nerve root is needed. In the lumbar spine it is commonly used to treat spinal claudication caused by spinal stenosis, and is considered the most effective treatment for this condition based on current evidence. [3]
The test involves removing 30–50 ml of CSF through a lumbar puncture, after which motor and cognitive function is clinically reassessed. [1] The name "Fisher test" is after C. Miller Fisher , a Canadian neurologist working in Boston, Massachusetts, who described the test.
Given normal anatomy, the intracranial pressure will be reflected as a rapidly rising pressure measured from the lumbar needle, within 10–12 seconds. If there is a stenosis in the spine, there will be a damped, delayed response in the lumbar pressure, thus a positive Queckenstedt's maneuver.