Spinal Tap or Lumbar Puncture
What is a spinal tap (lumbar puncture)?
A spinal tap, also called lumbar puncture, is done to measure the amount of pressure in the spinal canal and/or to remove a small amount of cerebral spinal fluid (CSF) for testing. Cerebral spinal fluid is the fluid that bathes your child's brain and spinal cord. In some cases, a spinal tap may also be done so medication can be injected into the spinal fluid, or to remove excess CSF in babies with hydrocephalus (a condition in which there is an overproduction or lack of absorption of the cerebral spinal fluid that is found inside the ventricles, fluid-filled areas, inside of the brain). A special needle will be used for the spinal tap.
Getting ready for the test:
Your child will lie on his/her side on a table and be asked to "curl up in a tight ball." Alternatively, he/she may be asked to lean over a table and grab his/her ankles. A technician or nurse will stand beside your child to help him/her hold very still and explain what the physician is doing. Remaining still is very important and will make the test go more smoothly. The physician will feel your child's back for a space between the bones of the lower part of the spine to insert the needle. The physician will clean your child's back with sponges and an antiseptic.
What is involved with the test?
The physician may numb the spot for the spinal tap by injecting a special medication or by applying a topical medication. This shot stings for a few seconds, but it will make the spinal tap less painful for your child. Then, the physician will put the special needle through the numbed skin, and into the space where the CSF is found. Your child will feel some pressure while the needle is being pushed in. He/she must stay very still. The CSF will begin to drip out of the needle and a small amount will be collected in test tubes.
If the physician needs to inject medication in the spinal canal, it will be given through the same needle after the CSF is collected. When the test is completed, the needle will be removed and an adhesive bandage will be placed over the injection site. The test tubes will be taken to the lab.
Sometimes, intravenous (IV) conscious sedation may be used for the procedure. On rare occasions, the spinal tap is done while your child is under general anesthesia. If anesthesia is used, your child will not be allowed any food or drink from the night before the test until after the test is completed. Your child may remain sleepy for a short time after the test is complete. Usually, when anesthesia is used, the child is not aware of the test and will not remember it later.
What happens after the test?
Lying flat in bed for 30 minutes to one hour may help to prevent your child from getting a headache. Reading and playing quietly will help your child stay in bed. Your child's physician will discuss the lab report and treatment plan with you. Some of the studies can be completed in one day while others may take two or three days. Your child's physician and nurses will be available to answer your questions.