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Lumbar puncture : anatomical review of a clinical skill

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Boon, J. M., Abrahams, Peter H., Meiring, J. H. and Welch, T. (2004) Lumbar puncture : anatomical review of a clinical skill. Clinical Anatomy, Vol.17 (No.7). pp. 544-553. doi:10.1002/ca.10250

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Official URL: http://dx.doi.org/10.1002/ca.10250

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Abstract

The safe and successful performance of a lumbar puncture demands a working and specific knowledge of anatomy. Misunderstanding of anatomy may result in failure or complications. This review attempts to aid understanding of the anatomical framework, pitfalls, and complications of lumbar puncture. It includes special reference to 3D relationships, functional and imaging anatomy, and normal variation. Lumbar puncture is carried out for diagnostic and therapeutic purposes. Epidural and spinal anesthesia, for example, are common in obstetric practice and involve the same technique as diagnostic lumbar puncture except that the needle tip is placed in the epidural space in the former. The procedure is by no means innocuous and anatomical pitfalls include inability to find the correct entry site and lack of awareness of structures in relation to the advancing needle. Headache is the most common complication and it is important to avoid traumatic and dry taps, herniation syndromes, and injury to the conus medullaris. With a thorough knowledge of the contraindications, regional anatomy and rationale of the technique, and adequate prior skills practice, a lumbar puncture can be carried out safely and successfully. Clin. Anat. 17:544–553, 2004. © 2004 Wiley-Liss, Inc.

Item Type: Journal Article
Divisions: Faculty of Medicine > Warwick Medical School
Journal or Publication Title: Clinical Anatomy
Publisher: John Wiley & Sons Ltd.
ISSN: 0897-3806
Official Date: 2004
Dates:
DateEvent
2004Published
Volume: Vol.17
Number: No.7
Page Range: pp. 544-553
DOI: 10.1002/ca.10250
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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