Spinal tap, or most commonly known as Lumbar Puncture, is a medical procedure that is performed on the lumbar region of the spine. The Spinal Tap is done to diagnose infections or neurological disorders like Meningitis, Epilepsy, Guillain-Barre syndrome, and Multiple Sclerosis. It can also be administered to provide anesthetic medications or chemotherapy drugs into the cerebrospinal fluid.
The lumbar region refers to the lower back area, which consists of vertebral bones, intervertebral discs, ligaments, nerves, blood vessels, and muscles. The spinal cord ends at the lumbar spine, and its remaining nerve endings branch out towards the end of the spinal canal.
What Are the Myths Associated with Spinal Tap?
Myths and misconceptions about the spinal tap stem from fear and unawareness. A few of them are debunked below:
- Myth: Spinal Tap is extremely painful.
Since the procedure of Spinal Tap includes a needle insertion in the lower back, people almost generally associate it with pain. However, the reality is that this procedure involves the administration of local anesthesia, which numbs the lower back. The procedure sometimes does sting a little, but it is bearable.
- Myth: Spinal Tap can leave a person paralyzed.
This is a common misconception. A Spinal Tap is done at about 5 inches below the spot where the spinal cord ends, hence reducing the chances of any nerve damage. A Spinal Tap, therefore, will not leave you paralyzed.
- Myth: Spinal Tap can cause infections
- A Spinal Tap is administered in a very safe and sterilized environment. Utmost care is taken to clean everything. Thus, a Spinal Tap will not cause infections .
- Myth: Spinal Tap causes headaches.
25 out of 100 cases may experience mild headaches after a Spinal Tap. It is usually not bothersome and resolves in a couple of hours. Researchers have found that the severity of headaches depends mostly on the size of the needle used.
- Myth: Spinal Tap causes excessive bleeding.
When a small blood vessel is ruptured during this procedure, it may cause minimal bleeding. Usually, no treatment is required.
When Are Spinal Taps Performed?
A Spinal Tap or Lumbar Puncture is performed to rule out the risk of any infections or other disorders related to the spinal cord or brain. It is usually performed for the following reasons:
- To collect cerebrospinal fluid for analysis.
- To administer chemotherapy drugs, anesthetics, or other drugs.
- To measure the pressure around the brain and spinal cord.
- To inject dyes in a myelography or radioactive materials into the cerebrospinal fluid.
The information gathered from the samples collected by a Spinal Tap help diagnose bacterial infections, brain hemorrhage, inflammatory conditions such as Multiple Sclerosis and Guillain-Barre syndrome in the central nervous system, or unknown headaches. Conditions like Encephalitis (a brain inflammation caused by a virus), Reye syndrome, Myelitis (inflammation of spinal cord and brain), Neurosyphilis (a bacterial infection of the Central Nervous System), and Pseudotumor Cerebri also can be diagnosis by CSF analysis through a Lumbar Puncture.
What Is the Procedure of a Spinal Tap?
The procedure for a Spinal tap or Lumbar Puncture involves the insertion of a thin and hollow needle in the lumbar region to extract cerebrospinal fluid surrounding the Spinal cord that surrounds the spinal cord and brain. CSF a helps in the supply of nutrients to the brain and the removal of waste products.
The procedure usually takes place in three stages.
- Preparation stage.
This starts a few days before the actual procedure. In this stage, your doctor or health care professional would inquire about your medical history, physically examine you, and suggest some blood tests to check for any blood clotting disorders. A CT scan or an MRI may also be ordered. In this stage, your doctor might suggest a special diet as well.
- During the procedure.
The Spinal Tap is usually done in a well equipped medical facility. Once the procedure starts, you would be lying down on your side with your knees drawn towards your chest. This position opens up the spaces between your vertebrae, making it easier for the doctor to insert the needle. Local anesthesia will be administered to your back to numb the area. A thin and hollow needle will be inserted about 5 inches below the end of the spinal cord.
The needle enters the area between the two lower vertebrae (lumbar region), passes through the spinal membrane (dura), and enters into the spinal canal. Once the needle is inserted successfully, the pressure of the cerebrospinal fluid is measured, and a small sample is collected.. This complete procedure lasts for about 50 minutes.
- After the procedure.
Once the procedure is complete, you will be required to lay flat for a while. Strenuous exercise is strictly restricted for at least 36 hours post the procedure . Your doctor will advise you to drink an adequate amount of water and remain hydrated. The procedure does not restrict you from doing your daily activities though.
What Are the Results of a Spinal Tap?
Once the samples of the extracted cerebrospinal fluid are sent to a laboratory for examination. There will be parameters to examine the sample appropriately. A few of them are:
- Presence of white blood cells.
The presence of more than five white blood cells (mononuclear leukocytes) per microliter of spinal fluid may be a sign of infection.
The presence of viruses, bacteria, and other microorganisms in the spinal fluid is a sign of infection.
- Cancer cells.
The presence of a tumor or abnormal cells in the spinal fluid indicates cancer.
An increase in the level of protein in the spinal fluid may indicate inflammation in the central nervous system.
Low glucose levels in the spinal fluid may indicate infections.
If the colorless and spinal fluid seems pink in color, it might suggest abnormal bleeding. If the spinal fluid is greenish, it indicates infections.
What Are the Complications Associated with Spinal Taps?
Although Spinal Tap is a relatively safe procedure, there are a few risks associated with it. These risks include
Only 25% of the cases have reported headaches but these are not of concern . Headaches after a spinal tap might be due to the leakage of fluids into the nearby tissues.
- Pain or discomfort.
A sense of discomfort or pain in the lower back region may occur after the procedure. This pain might also travel towards the legs. But, this tenderness lasts for a few hours only.
A small amount of bleeding might be caused due to a Spinal Tap, especially when the needle used in the procedure punctures any blood vessels.
- Brainstem herniation.
This condition is characterized by the increase in pressure within the skull caused due to a brain tumor or lesion. To avoid such a situation, your doctor would advise you to go through a CT scan or MRI to identify any tumors.
When Do you Need to See a Doctor?
You must check with your doctor if you find any anomalies like the following.
- Numbness or tingling sensation in the legs.
- Abnormal bleeding in the injection site.
- Inability to urinate.
- Severe and persistent headaches.
A Spinal Tap is generally a safe procedure that is administered under expert supervision and an extremely sterile environment. There are very few complications related to this procedure, and thus, there is no need for any concern .
Frequently Asked Questions (FAQs)
- Does the Spinal Tap or Lumbar Puncture procedure last long?
The procedure for Lumbar Puncture lasts somewhere around 40 to 50 minutes, depending on the patient.
- How long does it take to recover from a spinal tap?
The recovery from a spinal tap procedure varies from person to person. It may take a couple of hours to a few days for recovery. For a speedy recovery, do not do any strenuous activity.
- Is a Spinal Tap the same as an epidural?
No, they are not the same. In the Spinal Tap procedure, a needle is used to extract spinal fluid. In an epidural, a catheter is inserted through a needle, and the tube is left in the epidural space in the back.