Information on Lumbar Puncture (LP)

What is Lumbar Puncture (LP)

LP means the insertion of a needle into the lower part of the spinal canal and the collection of cerebrospinal fluid, in places where the spinal cord no longer passes, so there is no risk of its damaging.

The reason for this procedure is most often diagnostics (clarification of the disease cause), less often therapeutic LP can be performed (reduction of the increased cerebrospinal fluid pressure).

Preparation for the procedure

Prior to the procedure, a CT scan of the brain or a background eye examination is performed to rule out increased pressure in the cranial cavity. No special preparation is necessary, only in some cases we administer medication to relax the spinal muscles, disinfect the injection site and if necessary shave it. Prepare for the following resting regime (shower, toilet before the procedure).

Procedure method

The procedure is most often performed sitting up, in some cases also lying down. Sterile requirements are observed (disinfection of the injection site, sterile gloves, disposable needle). After disinfecting the injection site, the doctor palpates the injection spot, the patient "arches" the lumbar spine against the doctor and, most often between the 4-5th lumbar vertebrae, the needle is inserted into the spinal canal. After collecting cerebrospinal fluid for all examinations, the puncture needle is withdrawn and the site is sterilely covered. On the same day we will have basic information to rule out or confirm infection of the nervous system; the appearance of the cerebrospinal fluid checked immediately after the puncture may also give a clue.

Arrangements

After the procedure, the patient stays in bed for 24 hours, of which 2 hours after the procedure he lies on the stomach, optimally without a pillow if he can. Adequate fluid intake (no-sugar tea, regular table water, not mineral water or juice) is essential. The attending physician will also prescribe infusion therapy to supplement fluids.

The doctor may offer you to perform a procedure called "atraumatic needle", which is paid – the fee is 150 CZK – in this case the resting period after the procedure is 2 hours only.

Complications

Despite all efforts, these cannot be completely eliminated; the staff of the Infectious Diseases Department strives to minimize the risk of complications.

Regardless of the length of the procedure, predisposed patients may experience a brief fainting episode (which resolves after the patient is laid down). Please advise us if you have experienced this condition before.

Even if sterile conditions are maintained, it is rarely possible to transmit and infection from an undetectable source in the patient's body into the cerebrospinal fluid. In the following days after the procedure, some patients may experience a drop in cerebrospinal fluid pressure (so-called post-puncture syndrome), manifested by headache on standing, dizziness, feelings of vomiting... The risk of post-puncture syndrome is minimized by observing the above-mentioned measures. Post-puncture syndrome is unpleasant, may last for several days, but is not dangerous, and can be managed relatively well with symptomatic therapy.