Lumbar puncture, also called a spinal tap, is the procedure doctors use to obtain a sample of cerebrospinal fluid (the liquid that surrounds the brain and spinal cord) for tests. Cerebrospinal fluid (CSF) is formed in special areas of the brain called ventricles. It flows down from the ventricles into the area around the spinal cord. CSF is usually clear and contains small amounts of proteins and glucose (sugar).
The October 25, 2006, issue of JAMA includes an article about lumbar puncture to diagnose meningitis. This Patient Page is based on one previously published in the October 23/30, 2002, issue of JAMA.
Suspected meningitis (infection of the covering of the brain and spinal cord)
Leukemia or lymphoma
Evaluation for neurological diseases, such as multiple sclerosis, neuropathy, or recurrent seizures
Fever of unknown origin
Lumbar puncture is also done by anesthesiologists to administer spinal anesthesia (also known as subarachnoid block) for some types of surgery.
For cancer treatment, chemotherapy medications are sometimes injected directly through the lumbar puncture needle into the CSF. The medicine flows freely in the CSF and can go to the brain or spinal cord where it is needed.
During a lumbar puncture, you either lie on your side or sit upright. Your back is scrubbed with an antiseptic solution. Local anesthetic medicine is injected into the skin. When the skin is numb from the local anesthetic, a small needle is inserted into your back at the level of the hip bones below the bottom of the spinal cord. The needle is pushed forward gently until the CSF is found. For testing, 1 to 2 teaspoonfuls of fluid are removed and put into special sterile tubes. If you are receiving spinal anesthesia for surgery, no spinal fluid is drained out. The anesthetic medicine is injected directly into the CSF, and your legs and buttocks will begin to feel numb.
Sometimes lumbar puncture can be difficult to perform. Persons who have had back surgery, who have an abnormal back shape such as scoliosis (curvature of the spine), are pregnant, or are very obese are at risk for difficulty in the lumbar puncture. Lumbar puncture is easier to perform if the patient follows positioning instructions completely.
Grahic Jump Location
American Academy of Pediatricshttp://www.aap.org
American Society of Anesthesiologists http://www.asahq.org/patienteducation.htm
To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: American Academy of Pediatrics, American Society of Anesthesiologists
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
TOPIC: DIAGNOSTIC TESTS
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
The Rational Clinical Examination Make the Diagnosis: Lumbar Puncture to Diagnose Bacterial Meningitis
The Rational Clinical Examination Original Article: How Do I Perform a Lumbar Puncture and Analyze the Results to Diagnose Bacterial Meningitis?
All results at JAMAevidence.com >
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.