A spinal tap, also referred to as a lumbar puncture (LP), is a medical procedure where spinal fluid is extracted from the spinal canal for diagnostic purposes. It is particularly useful for diagnosing inflammatory conditions, such as infections. Additionally, it can provide insights into diagnosing tumors and cancers affecting the central nervous system. The term "lumbar puncture" originates from the needle's insertion into the lumbar region of the back. Other names for this procedure include spinal puncture, thecal puncture, and rachiocentesis.An LP is primarily performed to obtain a sample of cerebrospinal fluid (CSF) for examination. However, it can also be used therapeutically to administer medications like antibiotics or cancer treatments directly into the spinal canal. Occasionally, spinal fluid is withdrawn to reduce pressure in certain rare conditions, such as normal-pressure hydrocephalus.During the procedure, the patient usually lies on their side, although it can also be done while sitting up, especially in infants. After a local anesthetic is applied to the lumbar area, a needle is inserted between the vertebrae into the spinal canal, typically between the 3rd and 4th lumbar vertebrae. This allows for the measurement of spinal fluid pressure and the collection of CSF for analysis.CSF circulates around the brain and spinal cord, providing buoyancy and protection. Normally, CSF contains specific chemicals like proteins and glucose, and has minimal cellular presence, along with a standard pressure upon removal. The typical values are:- Protein: 15-45 mg/dl- Glucose: 50-75 mg/dl- Cell count: 0-5 mononuclear cells- Initial pressure: 70-180 mmThese values can change due to injury or disease affecting the brain, spinal cord, or surrounding tissues. The CSF is routinely tested for infections in a microbiology lab.The fluid collected through an LP can help diagnose serious conditions, including brain hemorrhage, increased pressure from hydrocephalus, meningitis, and tumors of the brain or spinal cord. Moreover, it can reveal diseases affecting other systems.While removing spinal fluid during an LP, potential risks include headaches, brain herniation, bleeding, and infection, though they are rare except for headaches, which can occur hours to a day post-procedure. The likelihood of headaches is reduced if the patient stays flat for 1-3 hours afterward. Despite the risks, an LP can provide crucial, sometimes lifesaving, information.
