Virtual Children's Hospital: CQQA: Lumbar Puncture (Spinal Tap)

Pediatrics Common Questions, Quick Answers

Lumbar Puncture (Spinal Tap)

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: June 2002
Last Revision Date: June 2002

Common Questions, Quick Answers

What is a lumbar puncture?

A lumbar puncture (LP) is also called a spinal tap.
In the procedure, a doctor inserts a needle into fluid in the spinal canal.
The needle is put into the "lumbar," or small of the back.
A sample of cerebrospinal fluid (CSF) is taken. CSF protects the brain and spinal cord from injury.

Why does my child need this procedure?

An LP is usually done for testing purposes (to see if your child has an illness or infection).
It is commonly used to test for bleeding around the brain or inflammation of the brain, spinal cord, or nearby tissues.
It is used to test for meningitis, lymphoma, leukemia, or other cancers of the brain or brain system.
It is used to test for diseases of the immune system, such as multiple sclerosis.
An LP can also be used in treatment (to put medicine in the body to fight illness and disease).
An LP is sometimes done to take spinal fluid out to decrease pressure.

What are the benefits?

What are the risks?

Headaches may occur within hours or days after LP.
There is less risk of headache if child lies flat for 1-3 hours after LP.
Risks also include bleeding and infection.
The child needs to stay still so that the needle doesn't move and injure the spinal cord.
Some children may have a backache after the test.

Is it painful?

It will feel cold and wet when the back is washed and cleaned.
Your child will be given a pain numbing medication (anesthetic) by needle. It will sting when first given in the back.
Your child will feel hard pressure when the needle is put in and some short-lasting pain that should stop in a few seconds.
Discomfort is minimal to moderate.

How do we prepare for this procedure?

How is it done?

You must sign a consent form. Talk to your doctor if you have questions or concerns.
The child will usually need to lay down on his side with knees tucked up towards his chest and chin down (fetal position).
Sometimes, the procedure can be done with a child or baby sitting up.
The skin is cleaned where the needle will be put in.
A pain numbing medicine (anesthetic) is put into the small of the back with a needle.
Next, a needle is inserted into the spinal canal.
With the needle in, the doctor can measure fluid pressure. Fluid is removed for testing. The needle is taken out.
The area is cleaned again and covered with a bandage.
The needle is in the back for a few minutes.
The whole procedure takes about 30 minutes to perform.

What care will my child need after the procedure?

The child should stay in the doctor's office and lie down for 15 minutes. Then, he can go home.
He should lie down at home for 6-8 hours. Lie flat on his back if possible.
Lying down reduces the chance that he will get a headache.
Drink extra fluids for the next 24 hours.
Rest and quiet activities for the next 24 hours.

What do the results mean?

The doctor commonly measures the fluid for protein, glucose (sugar), cell count, the types of cells, and pressure.
If values do not fall within a normal range, it could be a sign that your child has an injury or disease of the brain, spinal cord, or nearby tissues.

When should I call the doctor?

Call the doctor if your child has a severe headache that lasts for more than 24 hours after an LP.
Call the doctor if there is sign of infection, such as fever or chills.
Call the doctor if there is redness, swelling, pain, bleeding, or discharge from the area where the needle was put in.
Call if your child describes feeling tingly.
Call if your child describes numbness in his lower back or legs.
Call if your child is having problems with urination.
Call the doctor if you have questions or concerns about your child's condition.

Quick Answers

A lumbar puncture (LP) is also called a spinal tap.
An LP is usually done for testing purposes (to see if your child has an illness or infection).
LPs give the doctor valuable information.
Headaches may occur within hours or days after LP.
Your child will feel hard pressure when the needle is put in and some short-lasting pain.
Ask your doctor how the procedure is done. Talk to your child about what is going to happen.
With the needle in, the doctor can measure fluid pressure. Fluid is removed for testing. The needle is taken out.
Your child should lie down for 6-8 hours after the procedure.
If results are not normal, it could be a sign that your child has an injury or disease of the brain, spinal cord, or nearby tissues.
Call the doctor if you have questions or concerns about your child's condition.

References

MedicineNet. Lumbar Puncture. 1998 October 14 (cited 2002 March7).
MEDLINEplus: Medical Encyclopedia. CSF Collection. 2001 July 26 (cited 2002 March 7).
The PDR Family Guide Encyclopedia of Medical Care. Spinal Tap. Methodist Healthcare. 1997 (cited 2002 March 8).

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