Lumbar puncture

Lumbar puncture is a good way to treat some spinal diseases, but before we do it, we need to make relevant preoperative preparations, and better understand the operation method of lumbar puncture, or the steps during the operation, and postoperative care, which will be more beneficial for our disease recovery.

Before lumbar puncture, if the patient has increased intracranial pressure caused by infectious cerebral edema, intravenous mannitol can be used for dehydration before the operation to reduce edema and effectively lower intracranial pressure. If the patient becomes restless and uncooperative, a sedative should be given before surgery.

The patient lies on his side with his head bent toward his chest, his waist arched backward, his knees bent toward his abdomen, and his spine close to the edge of the bed. Fix the skin at the puncture point with your left hand, hold the puncture needle with your right hand, and slowly insert it between the intervertebral spaces, perpendicular to the spine or with the needle tip slightly obliquely toward the head. The needle insertion depth is about 4 to 6 cm for adults and 2 to 3 cm for children. When the needle passes through the ligament and dura mater and enters the subarachnoid space, the resistance suddenly disappears, and cerebrospinal fluid flows out when the needle core is pulled out. Collect 2 to 5 ml of cerebrospinal fluid in a test tube for testing. When intracranial pressure increases, it is not advisable to release too much fluid, 2 to 3 ml is enough.

After the puncture needle enters the intervertebral space, if there is resistance, do not force it in further. The needle tip needs to be withdrawn to the subcutaneous tissue and then the direction of needle insertion should be adjusted. The force used during puncture should be appropriate to avoid excessive force which may damage the tissue and make it difficult to feel the disappearance of resistance. If a large thick needle is used for puncture, attention should be paid to whether there is cerebrospinal fluid leakage and the resulting intracranial hypotension syndrome. If this occurs, the patient can be advised to drink more water or receive an intravenous drip of 0.5% sodium chloride hypotonic solution.

We have a certain understanding of the operation mode and precautions of lumbar puncture, as well as postoperative care. However, we recommend that when patients use lumbar puncture to treat diseases, they should still pay attention to the occurrence of contraindications, do a good job of preoperative examinations, and take timely treatment and avoidance measures if there are any discomforts.