Pediatrics Common Questions, Quick Answers

Lumbar Puncture (Spinal Tap)

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: June 2002
Last Revision Date: June 2002

• What is a lumbar puncture?
• Why does my child need this procedure?
• What are the benefits?
• What are the risks?
• Is it painful?
• How do we prepare for this procedure?
• How is it done?
• What care will my child need after the procedure?
• What do the results mean?
• When should I call the doctor?

What is a lumbar puncture?

• A lumbar puncture (LP) is also called a spinal tap.
• In the procedure, a doctor inserts a needle into fluid in the spinal canal.
• The needle is put into the "lumbar," or small of the back.
• A sample of cerebrospinal fluid (CSF) is taken. CSF protects the brain and spinal cord from injury.

Why does my child need this procedure?

• An LP is usually done for testing purposes (to see if your child has an illness or infection).
• It is commonly used to test for bleeding around the brain or inflammation of the brain, spinal cord, or nearby tissues.
• It is used to test for meningitis, lymphoma, leukemia, or other cancers of the brain or brain system.
• It is used to test for diseases of the immune system, such as multiple sclerosis.
• An LP can also be used in treatment (to put medicine in the body to fight illness and disease).
• An LP is sometimes done to take spinal fluid out to decrease pressure.

What are the benefits?

• LPs give the doctor valuable information.
• The information could save your child's life.
• Results could show that your child has an injury, illness, or disease.
• It can give treatment to your child.

What are the risks?

• Headaches may occur within hours or days after LP.
• There is less risk of headache if child lies flat for 1-3 hours after LP.
• Risks also include bleeding and infection.
• The child needs to stay still so that the needle doesn't move and injure the spinal cord.
• Some children may have a backache after the test.

Is it painful?

• It will feel cold and wet when the back is washed and cleaned.
• Your child will be given a pain numbing medication (anesthetic) by needle. It will sting when first given in the back.
• Your child will feel hard pressure when the needle is put in and some short-lasting pain that should stop in a few seconds.
• Discomfort is minimal to moderate.

How do we prepare for this procedure?

• Ask your doctor how the procedure is done.
• Prepare your child. Talk to him about what is going to happen.

How is it done?

• You must sign a consent form. Talk to your doctor if you have questions or concerns.
• The child will usually need to lay down on his side with knees tucked up towards his chest and chin down (fetal position).
• Sometimes, the procedure can be done with a child or baby sitting up.
• The skin is cleaned where the needle will be put in.
• A pain numbing medicine (anesthetic) is put into the small of the back with a needle.
• Next, a needle is inserted into the spinal canal.
• With the needle in, the doctor can measure fluid pressure. Fluid is removed for testing. The needle is taken out.
• The area is cleaned again and covered with a bandage.
• The needle is in the back for a few minutes.
• The whole procedure takes about 30 minutes to perform.

What care will my child need after the procedure?

• The child should stay in the doctor's office and lie down for 15 minutes. Then, he can go home.
• He should lie down at home for 6-8 hours. Lie flat on his back if possible.
• Lying down reduces the chance that he will get a headache.
• Drink extra fluids for the next 24 hours.
• Rest and quiet activities for the next 24 hours.

What do the results mean?

• The doctor commonly measures the fluid for protein, glucose (sugar), cell count, the types of cells, and pressure.
• If values do not fall within a normal range, it could be a sign that your child has an injury or disease of the brain, spinal cord, or nearby tissues.

When should I call the doctor?

• Call the doctor if your child has a severe headache that lasts for more than 24 hours after an LP.
• Call the doctor if there is sign of infection, such as fever or chills.
• Call the doctor if there is redness, swelling, pain, bleeding, or discharge from the area where the needle was put in.
• Call if your child describes feeling tingly.
• Call if your child describes numbness in his lower back or legs.
• Call if your child is having problems with urination.
• Call the doctor if you have questions or concerns about your child's condition.

Quick Answers

• A lumbar puncture (LP) is also called a spinal tap.
• An LP is usually done for testing purposes (to see if your child has an illness or infection).
• LPs give the doctor valuable information.
• Headaches may occur within hours or days after LP.
• Your child will feel hard pressure when the needle is put in and some short-lasting pain.
• Ask your doctor how the procedure is done. Talk to your child about what is going to happen.
• With the needle in, the doctor can measure fluid pressure. Fluid is removed for testing. The needle is taken out.
• Your child should lie down for 6-8 hours after the procedure.
• If results are not normal, it could be a sign that your child has an injury or disease of the brain, spinal cord, or nearby tissues.
• Call the doctor if you have questions or concerns about your child's condition.

References

• MedicineNet. Lumbar Puncture. 1998 October 14 (cited 2002 March7).
• MEDLINEplus: Medical Encyclopedia. CSF Collection. 2001 July 26 (cited 2002 March 7).
• The PDR Family Guide Encyclopedia of Medical Care. Spinal Tap. Methodist Healthcare. 1997 (cited 2002 March 8).

URL: http://www.virtualpediatrichospital.org/