Lumbar Puncture Fact Sheet

What is a Lumbar Puncture?

Lumbar Puncture is the insertion of a needle between two bones (vertebrae) of the lower spine to obtain a sample of cerebrospinal fluid (CSF). Fluoroscopic and Computed Tomography (CT) Imaging may be required for accurate needle placement; on some occasions a combination of imaging may be required.

A specialist known as an Interventional Radiologist often performs these procedures.  The procedure is sometimes called a spinal tap.

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Illustration of a Lumbar Puncture

Why do I need this procedure?

Your Doctor has asked for this test to be performed because you may experience some or all of the following;

  • Fever
  • Severe persistent headaches or neck stiffness
  • Loss of balance, clumsiness or lack of coordination
  • Ongoing confusion
  • Numbness, tingling or weakness in arms and/or legs
  • Headaches of Unknown Cause – after other avenues have been explored
  • Check for the presence of blood in the CSF
  • Measure the pressure of the CSF in the space surrounding the spinal cord

What should I expect?

  • The procedure can take between 20 – 60mins.
  • You may be required to take some time off work – please let the nurses know so they can organise a medical certificate for you. An attendance certificate can be provided for your carer on the day of your procedure.
  • Please make sure you have someone to pick you up after your procedure. You procedure will be cancelled if you don’t have an escort.  Please contact MIVIR as soon as possible if this cannot be arranged.

On the day of your Procedure

You will need to present to the Day Procedure Unit on the day of your procedure – your admission time will be sent to you with your appointment time.  This will allow the nurses time to complete your admission paperwork and any other tests that may be required such as blood tests or pre-medication.

You are not required to fast for this procedure, please maintain adequate fluid intake the day before your procedure date.  Please continue to take your blood pressure medication.  Please bring a list of your medications with you.

Please contact MIVIR if you are taking medication for the following;

  • Diabetes,
  • Stroke,
  • Heart Conditions such as a Heart Attack or Atrial Fibrillation.
Pre Procedure

Pre Procedure

You will be required to change into a hospital gown; you may leave your underwear on.  The strength and sensation in you legs will be assessed regularly throughout your stay.

Procedure

Procedure

You will be taken into the Angiography Suite and positioned on the table.  The best position for this procedure is lying on your left side with your knees drawn up to your chest.  Monitoring equipment will be attached so the nurses can monitor your blood pressure and heart rate throughout the procedure.  The area to be injected will be cleaned with a cold antiseptic solution and a sterile drape placed over the site. Local anaesthetic will be injected into the skin, which will sting for 15-20 seconds.  You should only feel pushing and pressure after this.

Post Procedure

Post Procedure

A small waterproof dressing will be applied to the injection site; you may remove the dressing in 12 hours. You may have some discomfort at the injection site, this will resolve over the next 12-24 hours.  During your time in the recovery room the nurses will monitor your blood pressure and heart rate and regularly check the puncture site for any signs of bleeding.  The nurses will also assess the strength and sensation in your legs before the procedure and during your stay in recovery after the procedure.  You will be given something to eat and drink as soon as you are able to sit up.  If you are staying overnight in the hospital, you will be taken to the ward after a short period in recovery.

Discharge

Discharge

If you are being discharged home, your recovery period is approximately 4 hours.  You must have someone to collect you and stay with you overnight.  You will be given a letter from the nurses with some discharge instructions and any other relevant information related to your procedure.  You may be required make a follow-up appointment with Dr Vrazas.  This can be made at your convenience by phoning MIVIR on 9411 7165.

At Home

At Home

We recommend the following;

  • Rest quietly for the next 12-24 hours.
  • No strenuous activity for the next 24-48 hours.
  • Call an ambulance or present to your nearest Emergency Department if you experience the following;
    • Swelling, bruising or pain at the injection site that continues to increase,
    • Ongoing headaches, fevers or neck stiffness,
    • Changes in strength or sensation when walking or standing.

Useful Links

Lumbar Puncture – Radiology Info

Author: Dr John Vrazas