Lumber Puncture Patient information leaflet (181kB pdf)
Introduction
We hope this guide will answer your questions about your lumber puncture procedure. Please contact the team if you require further information via the details at the end of this leaflet.
What is a lumber puncture?
A lumbar puncture is a procedure that involves using a needle to remove cerebrospinal fluid (CSF). CSF is the fluid that surrounds your brain and spinal cord.
Why do I need a lumber puncture?
Your physician will have discussed treatment options with you. It is a procedure to diagnose a neurological condition – your doctor can use your CSF to help diagnose your condition. It can also be used to treat a neurological condition – if your pressure of the CSF is too high, your doctors may do a lumbar puncture to remove some of the fluid.
Who will be doing the lumber puncture?
One of the radiologists (x-ray doctors) will perform the lumbar puncture. The radiologist will visit you before the procedure to talk about it with you. This is a good chance to ask any questions or talk about any worries you have about the procedure. Your doctor will ask you to sign a consent form.
What are the associated risks?
X-Ray radiation: All x-ray procedures involve exposure to radiation in varying amounts. The dose you get from a medical x-ray is very low and your doctor along with the radiologists have determined that the benefits of having the examination outweigh potential risks. The radiographer is present throughout your test making sure that the radiation dose is kept as low as reasonably possible and the duration and level of x-rays are kept to a minimum.
Procedure risks: A lumbar puncture is not dangerous. Serious side effects (meningitis or nerve root damage) after lumbar punctures are very rare. If the doctors think you are at risk of developing serious side effects, they will not perform the lumbar puncture. You may have headaches, which can last for up to a week – you’ll be given painkillers at the hospital if you need them. There may be swelling and lower back pain where the needle was inserted – this should get better on its own after a few days.
Preparing for your procedure
You MUST have a blood test before a lumbar puncture. You’ll need to have a blood test (Full Blood Count and INR) before you can have a lumbar puncture. We cannot proceed with your lumbar puncture without a blood test. You will be notified of a request for a blood test. Please book and attend for this test to be done prior to your lumbar puncture. For patients on warfarin, please contact the radiology nurses after your blood test but prior to your procedure. INR needs to be no more than 1.3 for the procedure to go ahead. You do not need to stop eating or drinking before the lumbar puncture. Wear loose clothing or a hospital gown to your lumbar puncture. Please leave any jewellery or valuables at home. Please contact the booking team before your appointment if:
- you are or think you may be pregnant
- you weigh over 30 stone/190 kilograms
- you plan on using hospital transport or need a hoist to transfer
- you require an interpreter – please inform us as soon as you receive your appointment letter, and we will arrange an interpreter for you
Allergies
Tell your doctor if you have any allergies.
Medication
Please continue to take all medications as usual prior to your examination. If you are taking anti-coagulants (blood thinners) please contact the radiology nurse on the number below.
Getting to us
Once you have arrived at The Princess Alexandra Hospital (Hamstel Road, Harlow, Essex,
CM20 1QX), follow the signage to the radiology reception, which is located on the ground floor, green zone. Please let the radiology receptionist know that you have arrived for your appointment.
When should I arrive?
Please arrive in the radiology department at your given appointment time. A notification
through text or letter should have been sent to you to confirm this appointment.
Can someone stay with me in hospital?
You may have a friend or relative attend with you, but they will be asked to stay in
the waiting area while you have your procedure.
Children are not allowed in the waiting area unattended. Our staff are not permitted to
supervise children, so please ensure child care arrangements are in place to avoid your
tests being rescheduled.
The procedure
Your identification will be checked by a nurse and a brief history will be taken. Before the procedure, the interventional radiologist will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish. We will ask you to lie down on your left side with your knees bent. You will need to stay as still as possible in this position while you have a lumbar puncture. Once you are lying down in the correct position, the doctor will clean an area on your back with antiseptic skin preparation and give you an injection of local anaesthetic. The local anaesthetic will make the injected patch of skin go numb. Once the skin is numb, the radiologist will insert a needle through the skin in the area between your spinal bones. This space contains the spinal fluid (CSF). A thin tube will attach to the needle to measure the pressure of the CSF. Some fluid will be dripped out from the needle so to collect and send to the lab to be tested. The needle will be removed and a sticky plaster will be placed on your back.
Is it uncomfortable?
The local anaesthetic will make the injected area of skin numb for about 45 minutes. So, it won’t hurt when the needle goes in. You may feel some pushing and pulling as the needle goes further in. Some people get a momentary shooting pain or electric shock feeling down their leg.
After the procedure
You will be taken back to the ward. Nursing staff will carry out routine observations including pulse and blood pressure and will also check the treatment site. You will generally stay in bed for a couple of hours and then you will be able to go home. Take it easy for the rest of the day but you can resume normal activities after 24-48 hours.
Can I drive after my procedure?
No, it is important that you have a responsible adult to escort you home. You must not
drive or use public transport for the journey home.
How soon can I return to work?
It is recommended that you rest for the remainder of the day. Avoid heavy lifting and gym exercise. You can return back to work after 24- 48 hours.
When will I get my results?
You will not know the results of your examination immediately. The radiologist will report their findings to the clinician who arranged your procedure, who will discuss the results with you.
Post lumbar puncture headache
This type of headache usually comes on 1 or 2 days after having a lumbar puncture. It usually lasts for about 2 days. A post lumbar puncture headache is made worse by standing up and is relieved by lying down. If you get a headache after a lumbar puncture:
- rest in bed – lie down flat for as long as you need
- drink plenty of fluids, ideally water – drinks containing caffeine (tea or
coffee) may help - take simple painkillers such as paracetamol
Contacting the team
- If you have any further questions about your procedure or an existing appointment, please contact the radiology department (Monday to Friday, 9am to 4pm) at01279 82 2527or 3405
- If you have any queries outside of working hours (after 4pm and on weekends), you will be redirected to the main radiology reception. Please note appointment bookings cannot be made during this time.
Your feedback matters
- If you would like to give feedback on your care, please contact our patient experience team at [email protected] or01279 827211.
- Please contact the communications team at [email protected] if you would like this leaflet in another language or format.