A Lumbar Puncture (LP), also called a spinal tap, is a procedure used to obtain a sample of cerebrospinal fluid for testing and/or pressure measurements.

You will first be asked to sit on the edge of the exam table, in a hunched forward position by hugging a pillow. Alternatively, you may lie on your side with your knees drawn towards your chin.

Next, your lower back will be scrubbed with a Betadine cleaning solution. Please let us know if you have any allergies to iodine. A local anesthetic will then be injected into the skin to numb the injection site. It is imperative that you remain as still as possible during this time.

When the skin is numb, a small spinal needle is inserted into the back at the level of your waist. The spinal cord ends just above this level so there is no risk of injury to the spinal cord.

The needle is passed gently between the bones of the spine until the spinal fluid is found. Approximately 3-4 tablespoons of fluid will then be extracted into sterile tubes. After the fluid is extracted, a band aid will be placed over the injection site, which you should leave on for a couple of hours.

The initial injection of the anesthetic stings for a brief moment – we will inform you when you feel this so that you hold as still as possible.

After an LP, you may experience minor pain, bruising or swelling of the skin at the insertion site.

The cause of the headache is leakage of spinal fluid around the puncture site. It will be important for you to lie down and keep your head flat. Only move in a slow manner. You should not make any sudden, jerking movements with your head or strain your back, because doing so will worsen your headache or further induce a leak.

Drink plenty of fluids during this period. Caffeinated beverages (coffee, tea & colas) appear to ward off as well as improve spinal headaches.

Mild analgesics like Tylenol, Ibuprofen or Aleve and a heating pad can be used to provide relief. You may also find ice packs to your forehead or back of neck soothing.

If you have discomfort in your lower back, this will be relieved with rest.

• You will need to inform your physician if you are on any blood thinning medications (such as Coumadin, Plavix, or Aggrenox).
• You will be asked to stop taking these medications 7 days prior to the LP.
• You may also be asked to increase your fluid intake the day before and asked to abstain from alcohol at least 24 hours before the procedure.
• You are encouraged to have a light meal the morning of your LP and encouraged to wear loose fitting clothing to the office.

When performed by an experienced practitioner, the LP is safe and involves minimal risks or discomfort.

A post LP headache can occur, however, less than 10% of patients who undergo an LP report a headache. These headaches are usually mild, typically last no longer than 2 days, and in very rare occasions, may last as long as a week. More severe headaches or headaches lasting longer than a week may require an additional procedure called a “Blood Patch.”

Patients who typically faint or feel nauseous when their blood is drawn may experience a similar sensation in response to an LP, either fainting or turning flush.

A very rare occurrence is an infection resulting from the spinal tap itself. The risk for such infection is less than that of a regular blood draw.

All reasonable precautions will be taken by our physicians to prevent potential problems and minimize risk.

After the procedure, you will be given fluids to drink, and the physician may ask you to rest in the office for 30 – 60 minutes.

When you go home, you should continue to drink plenty of non-alcoholic fluids during the next 12 hours.

You should also avoid heavy lifting and strenuous physical activity for 24 – 48 hours.