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Lumbar puncture

During a lumbar puncture, the physician will insert a needle into the lower spine:

To obtain cerebrospinal fluid (the fluid that circulates around the brain and spinal cord) to look for infection or cancer cells, or
To administer a chemotherapy agent for cancer patients, or
To monitor and relieve cerebrospinal fluid pressure for patients with pseudotumor

About this Treatment Pre and Post Operative Care Departments

How do we perform a lumbar puncture?

Your child will be placed on his or her side or stomach. We will inject local numbing medicine into the area around the spine. Using ultrasound or live X-ray (fluoroscopy) for guidance, the doctor will insert a needle into the spinal space. Once the needle is in the correct position, fluid will be removed and sent to the laboratory and/or medicine will be injected.

Will my child be awake for the procedure?

We will use either light sedation or a local numbing medicine depending on your child's age and medical history.

Will my child be in any pain?

Your child may feel a brief pinching sensation during needle insertion and some patients may feel mild tenderness and/or bruising around needle insertion site for a few days following the procedure.

What are the risks of a lumbar puncture?

The procedure is considered low-risk. However, potential complications include:

Infection
Bleeding
Nerve damage
Headache

Pre and Post Operative Care

How do my child and I prepare for the procedure?

We encourage good communication between you and your child, including the necessity and overview of the procedure as well as ensuring them that you are close by the whole time. Holding them or their hands until they leave for the procedure is a great way to provide support.

You will be given specific instructions along the way but you may need to arrive a few hours before the scheduled procedure to have some blood tests done. When you arrive at the hospital, a doctor will review the procedure and associated risks, after which you will sign a consent form. When we are ready to get started with the procedure, a nurse will place an intravenous line to deliver sedating medications and you will be allowed to accompany your child in the operating room until they are asleep, after which you will be escorted to a waiting room.

What should I expect after the procedure is complete?

After the procedure is complete, your child will need to lie on his or her back in the recovery area for one hour to minimize the chance of having a headache. Then your child will be able to go home or return to his or her hospital room.

When can my child bathe?

We will place a Band-Aid® or clear bandage and gauze over the site. Keep the area dry for 24 hours. After 24 hours, you may remove the bandage and your child may shower or take a bath as usual.

Are there any activity restrictions?

Though your child can resume normal school-going or daycare attendance, physical activity that can result in pulling of the tube should be limited, particularly contact sports and rough playing.

CONTACT CNMC IMMEDIATELY IF YOUR CHILD EXPERIENCES ANY OF THE FOLLOWING:

• Redness, pain, swelling, or bruising at the needle insertion site.

• Fever higher than 101^o Fahrenheit or 38^o Celsius.

• A change in color or temperature to the associated extremity.

• Numbness, swelling, or pain of the associated extremity.

The department of Interventional Radiology can be reached at: 202-476-3791, Monday through Friday, between 8 a.m. and 5 p.m.

At all other times please call 202-259-8643, which is the on-call pager. Follow the instructions and wait for a call back.

Departments

Interventional Radiology

Children’s National interventional radiologists perform a full range of minimally invasive, image-guided procedures to both diagnose and treat disease in infants, children, and adolescents.

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