Puncture of the spinal cord (lumbar puncture) is one of the most complex and responsible methods of diagnosis. Despite the name, the spinal cord itself is not affected, but a cerebrospinal fluid (CSF) is taken. The procedure involves a certain risk, therefore it is conducted only in case of acute necessity, in the hospital and specialist.
Why take a puncture of the spinal cord?
Puncture of the spinal cord is most often used to detect infections ( meningitis ), clarify the nature of the stroke, diagnose subarachnoidal bleeding, multiple sclerosis, identify inflammation of the brain and spinal cord, measure the pressure of the cerebrospinal fluid. A puncture can also be performed to administer medications or contrast media in an X-ray study to determine herniated intervertebral discs .
How is the spinal cord puncture taken?
During the procedure, the patient takes a position lying on his side, pressing his knees to his stomach, and his chin to his chest. This position allows you to slightly extend the processes of the vertebrae and facilitate the penetration of the needle. Place in the area of the puncture is disinfected first with iodine and then with alcohol. Then spend local anesthesia with an anesthetic (most often novocaine). Complete anesthesia does not give an anesthetic, so the patient must pre-tune into some unpleasant sensations in order to maintain complete immobility.
Puncture is carried out with a special sterile needle up to 6 centimeters long. They make a puncture in the lumbar region, usually between the third and fourth vertebrae, but always below the spinal cord.
After the introduction of the needle into the spinal canal, the cerebrospinal fluid begins to flow out of it. Usually about 10 ml of cerebrospinal fluid is required for the study. Also at the time of taking a spinal cord puncture, the rate of its expiration is estimated. In a healthy person, the cerebrospinal fluid is clear and colorless and flows at a rate of about 1 drop per second. In the case of increased pressure, the rate of outflow of liquid increases, and it can flow even with a trickle.
After obtaining the necessary volume of fluid for research, the needle is removed, and the puncture site is sealed with a sterile tissue.
Consequences of spinal cord puncture
After the procedure for the first 2 hours, the patient should lie on his back, on a level surface (without a pillow). In the next 24 hours it is not recommended to take a sitting and standing position.
In a number of patients, after they are given a spinal cord puncture, nausea, migraine-like pain, pain in the spine, lethargy may occur. To such patients, the attending physician prescribes pain relievers and anti-inflammatory drugs.
If the puncture was performed correctly, then it does not bear any negative consequences, and the unpleasant symptoms disappear quite quickly.
What is the danger of puncture of the spinal cord?
The procedure of spinal cord puncture is performed for more than 100 years, patients often have a prejudice against its purpose. Let's consider in detail, whether a puncture of a spinal cord is dangerous, and what complications it can cause.
One of the most common myths - when performing a puncture, the spinal cord can be damaged and paralysis may occur. But, as mentioned above, lumbar puncture is carried out in the lumbar region, below the spinal cord, and thus can not touch it.
Also, the risk of infection is a concern, but usually the puncture is performed under the most sterile conditions. The risk of infection in this case is approximately 1: 1000.
Possible complications after spinal cord puncture include the risk of bleeding (epidural hematoma), the risk of increased intracranial pressure in patients with tumors or other pathologies of the brain, as well as the risk of spinal cord injury.
Thus, if a qualified doctor performs a spinal cord puncture, the risk is minimal and does not exceed the risk of a biopsy of any internal organ.