spinal puncture; Lumbar puncture LP, medical procedure a needle is inserted into lower back

🧾 Definition
Spinal puncture (lumbar puncture) is a diagnostic and sometimes therapeutic procedure in which a needle is inserted into the subarachnoid space of the lumbar spine to withdraw cerebrospinal fluid (CSF) or administer medications.

It is typically performed between the L3–L4 or L4–L5 interspaces, below the termination of the spinal cord, to minimize risk of injury.

🎯 Purposes
Diagnostic:

Analyze CSF for infections (e.g., meningitis), hemorrhage, malignancy, or autoimmune conditions.

Measure intracranial pressure.

Therapeutic:

Administer intrathecal chemotherapy, antibiotics, or anesthetics.

Relieve pressure in certain conditions (rare).

🛠️ Procedure Overview
Preparation:

Patient consent and explanation.

Positioning: either lateral decubitus (fetal position) or sitting upright, leaning forward.

Aseptic technique with sterile drapes and gloves.

Needle Insertion:

Identify lumbar interspace (usually L3–L4).

Insert spinal needle through skin, ligaments, and dura into subarachnoid space.

CSF flows once the needle reaches the correct position.

Collection/Administration:

Collect CSF in sterile tubes for laboratory analysis.

Administer drugs if indicated.

Post-procedure:

Patient rests supine to reduce risk of post-lumbar puncture headache.

Monitor for complications (bleeding, infection, nerve irritation).

⚠️ Precautions
Contraindications: raised intracranial pressure (risk of herniation), local infection at puncture site, bleeding disorders.

Strict aseptic technique to prevent meningitis.

Gentle handling in neonates and pediatric patients.
#Puncture

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