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A lumbar puncture (LP) or spinal tap may be done to diagnose or treat a condition. For this procedure, your doctor inserts a hollow needle into the space surrounding the spinal column (subarachnoid space) in the lower back to withdraw some cerebrospinal fluid (CSF) or inject medication.
CSF is a clear fluid that bathes and cushions the brain and spinal cord. CSF is continuously made and reabsorbed in the brain.CSF is made up of cells, water, proteins, sugars, and other substances that are essential to maintain balance in the nervous system.
A lumbar puncture may be done for various reasons. 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 for red and white blood cells, protein, and glucose (sugar). The clarity and color of 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 in people who have an overproduction or decreased absorption of the fluid.
A lumbar puncture procedure may be helpful in diagnosing many diseases and disorders, including:
In addition, a lumbar puncture may be used to measure the pressure of the CSF. The doctor uses a special tube (called a manometer) to measures the pressure during a lumbar puncture.
Finally, a lumbar puncture may be done to inject medicine directly into the spinal cord. These include:
Your doctor may have other reasons to recommend a lumbar puncture.
Because this procedure involves the spinal cord and brain, the following complications may occur:
You may have other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.
How do I prepare for a lumbar puncture?
Check with your healthcare provider about what you should do before the procedure. Below is a list of common steps that you may be asked to do:
A lumbar puncture procedure may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.
Generally, a lumbar puncture follows this process:
You may have discomfort during a lumbar puncture. Your healthcare providers will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.
You usually will be asked to lie flat for about one hour after the lumbar puncture is completed. This helps reduce the incidence of a headache. You will be allowed to roll from side to side as long as your head is not elevated. If you need to urinate, you may need to do so in a bedpan or urinal during the time that you need to stay flat.
You will be asked to drink extra fluids to rehydrate after the procedure. This replaces the CSF that was withdrawn during the spinal tap and reduces the chance of developing a headache.
After recovery, you may be taken to your hospital room or discharged to your home. If you go home, usually your doctor will advise you to only engage in very light activity the rest of the day.
Once you are at home, notify your doctor of any abnormalities, such as:
If the headaches persist for more than a few hours after the procedure, or when you change positions, you should contact your doctor.
You may be instructed to limit your activity for 24 hours following the procedure. Generally, if no complications occur, you may return to your normal diet and activities.
Your health care provider may give you other specific instructions about what you should do after a lumbar puncture.
Before you agree to the test or the procedure make sure you know:
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