Spinal tap why is it done

If you take blood-thinners like warfarin, clopidogrel, or heparin or nonsteroidal anti-inflammatory drugs NSAIDs like aspirin, ibuprofen, or naproxen, you may need to stop these several days beforehand to reduce the risk of bleeding. Let your healthcare provider know about any other medications, supplements, or herbal remedies you're taking too. If you have health insurance, this test should be covered, but you may want to check with your insurance provider or agent to make sure, as well as to find out if you need preauthorization before you have the test.

You can also find out about any co-pay or co-insurance for which you may be responsible. If you don't have health insurance, consider calling around your area. Prices can vary greatly from facility to facility, but make sure you ask what the cost covers. In some cases, the price may reflect just the spinal tap alone without any diagnostic or healthcare provider's fees. Also, ask about discounts for paying right away or any income-based discounts. Since you will likely be lying down for an hour or two after your procedure, you may want to bring along a book or something else to do.

Bring your insurance card as well. You will need someone to drive you home after the procedure, so be sure to bring along a friend or family member, or organize to have a service pick you up when you're done. A healthcare provider, physician assistant, or nurse practitioner will perform your lumbar puncture and there may be an assistant there as well. If you have fluoroscopy or ultrasound, there may also be a radiologist or sonographer present.

You may need to fill out a consent form before you have this procedure. You'll need to change out of your clothes into a gown and then lie on your side on a table or your hospital bed in a fetal position with your knees tucked up toward your chest. Alternatively, you may be asked to sit on the edge of the table or bed and bend forward, leaning on something stable with your back to the healthcare provider.

These positions widen the area between your lumbar bones vertebrae , allowing for easier access. If your child is the one having the lumbar puncture, he or she may have intravenous IV sedation at this time, but most kids do just fine with the local anesthetic that's typically used.

The spinal tap itself usually takes about 45 minutes to an hour, plus recovery time. Your lower back will be cleaned with a sterilizing agent such as iodine and a local anesthetic, usually lidocaine, will be injected into your skin to numb the area.

The injection of the numbing medication can cause a sharp poke and slight burning sensation. Once your back is numb, the neurologist will insert a thin, hollow needle between two of your vertebrae into the thecal sac. You will need to hold very still for this. Sometimes the needle has to be repositioned to find the right spot. You may feel pressure or a twinge of pain or numbness down your leg when the needle is inserted.

For infants and young children, an ultrasound machine may be used to help guide the healthcare provider in placing the needle. A technician may help hold your child still as well, especially if he or she hasn't been sedated. The discomfort level can vary from one person to the next.

If you are obese or have degenerative bone disease, your medical team may opt to use fluoroscopy to lower the risk of a misplaced needle and avoidable pain. Once the needle is in place, what happens depends on why you're having the lumbar puncture.

The neurologist may measure the pressure of your CSF using a gauge called a manometer. The neurologist may measure the pressure of your CSF again after the fluid has been collected.

Medication like antibiotics, chemotherapy, anesthesia, or dye may be injected if you're having the lumbar puncture for this purpose. If not, or once the substance is injected, the needle is removed and a bandage is placed over the site.

You may be asked to lie down flat for an hour or two after this procedure. You'll also be given fluids to help prevent dehydration. Both of these steps can help decrease your chance of developing a headache from the lumbar puncture. When you're discharged, you'll be able to go back to your hospital room if you're hospitalized or home with your driver.

You'll need to take it easy for the rest of the day, but if you don't have a physically active job, you may be able to go back to work as long as you feel up to it. Be sure to ask your healthcare provider ahead of time about this. Keep drinking water to make sure you stay hydrated. Your healthcare provider may give you more specific instructions. You may notice some back pain, numbness, or soreness that can feel like it's radiating down your legs after the procedure for a few days.

If it's bothersome, try over-the-counter pain relievers such as Tylenol acetaminophen to help relieve the discomfort. Headaches can begin a few hours up to two days after your spinal tap. They're often minor, but sometimes they're accompanied by nausea, vomiting, dizziness, and a stiff neck. If you experience a headache after a spinal tap, Tylenol acetaminophen can often help. Caffeine can also relieve pain and help promote CSF production.

Try lying down since being upright can make the pain worse. Sometimes the headache persists for a few days to a week after the lumbar puncture, which may mean that the needle has left a hole in your thecal sac and fluid is still leaking out. In this case, a procedure called an epidural blood patch—in which your own blood is injected into the thecal sac—may relieve your headache as it slows down the leakage.

Your test results may take several days or weeks to come back, depending on the type of test that's being done. For instance, if a culture is being done on your CSF, this is a more complex test that will take more time. In emergency cases, simple test results may be available much sooner.

When cerebrospinal fluid is tested, a number of factors are considered, including:. If your lumbar puncture was performed on an outpatient basis to help diagnose your symptoms, your healthcare provider will likely have you come in for a follow-up appointment to discuss your test results, as well as potential next steps. When combined with other test results, as well as your symptoms, medical history, and physical exam, the information from a lumbar puncture can help pinpoint a diagnosis.

In cases where you have an infection like meningitis or encephalitis, testing your CSF can tell your healthcare provider whether your infection is bacterial, viral, or fungal.

This helps him or her know better how to treat you. You may need to have additional testing to figure out the specific cause of your symptoms. You can ask the doctor if it is OK for you to stay. The spinal cord extends from the lower part of the brain down to the upper lumbar area. A spinal tap is done in the lower lumbar area, below the point where the spinal cord ends.

So, the risk of harming the spinal cord is avoided. A spinal tap is not surgery. No stitches or long recovery time are needed. Someone getting a spinal tap might be awake, or may get medicine to help them relax or sleep during the test. The medicine can be given by mouth, into the nose, or through an IV.

Patients are positioned with their back curved so the spaces between the vertebrae are as wide as possible. This makes it easier for the doctor to insert the needle. Older children may be asked to either sit on an exam table while leaning over with their head on a pillow or lie on their side. Infants and younger children are placed on their sides with their knees near their chin. They will be held in this position during the test. Then, the doctor cleans the area where the spinal needle will go in, and might put a cream on the skin before using a tiny needle to numb the area.

The cream eases the discomfort of the needle, although the injection may still burn a little. The spinal needle used for the "tap" is thin with a hollow core. Inside the core is a "stylet," another type of thin needle that acts kind of like a plug. When the patient is in position, the doctor carefully inserts the spinal needle between two vertebrae. When the needle reaches an area called the spinal canal, the doctor slowly pulls out the stylet, which lets the cerebrospinal fluid drip into the collection tubes.

This takes only a few minutes. Then, the doctor puts the stylet back into the needle, withdraws the needle, and puts a bandage on the site.

The sample goes to a lab for testing. If you were not in the room with your child during the test, you can come in after the sample is collected. The doctor might want your child to lie down on their back for an hour or so after the test. A spinal tap lumbar puncture, or LP is a procedure in which a doctor inserts a needle into the space between two vertebrae in your lower spine to remove about a tablespoon of cerebrospinal fluid CSF , which bathes the tissues of the spinal cord and brain.

Spinal taps were initially part of the routine work-up for people suspected of having multiple sclerosis but became less common in recent years. However, the most recent set of guidelines on how to diagnose MS have recommended more widespread use of spinal taps Thompson and colleagues. Spinal taps are generally performed for two reasons. The most common is to confirm a diagnosis of MS.

MS is a clinical diagnosis based on a neurological exam and the neurological symptoms you report, such as nerve tingling, nerve pain, impaired vision, muscle weakness and so on.

Supporting evidence is obtained from magnetic resonance imaging MRI , which can detect areas of inflammation MS lesions in the brain and spinal cord. An MS diagnosis is made if there is evidence of two neurological events such as two relapses, or old and new lesions on an MRI affecting at least two areas of the brain as demonstrated by the type of symptoms you have or by an MRI.

For example, if the person has impaired vision and difficulty walking, this indicates that two different areas of the brain are affected.

These diagnostic criteria may appear clear-cut, but they can be less obvious in the real world. So a spinal tap can add to the evidence of whether or not a person has MS.

The CSF of most people with MS contains proteins antibodies which, when spun in a centrifuge, form distinct bands.