A lumbar puncture or spinal tap may be performed for a number of reasons including diagnostic, investigative or therapeutic. It is an extremely technique-sensitive procedure that involves careful insertion of a needle between two lumbar vertebrae — bones of the spine near the lower back — to remove a sample of cerebrospinal fluid (CSF).
The procedure is performed with the patient in an upright position or commonly in the fetal position. A small amount of local anesthesia is injected at the site of entry to make the procedure more bearable.
Risks Associated With Spinal Tap
A spinal tap procedure is considered to be safe and does not have any absolute contraindications, however, there is the risk of certain complications even when proper infection control and technique have been observed.
Herniation Of The Brain
Herniation of the brain following a spinal tap is extremely rare but it is also among the most serious complications that can occur. If the intracranial pressure is increased prior to the procedure or there is some amount of swelling then a change in CSF levels following a spinal tap can lead to compression of the brain stem or top of the spinal column.
The doctors will take a radiographic image of your brain prior to performing the procedure so that this possibility can be ruled out.
Since the procedure is aimed at collection of CSF, any small leakage that persists after the procedure has been performed will lead to the development of a headache. The severity of this headache is proportional to the size of the leak.
In general, this headache can appear several hours or even a couple of days after the procedure has been performed. People find that their headache is worse on standing up and reduced when lying down. A post-spinal tap headache can last for several weeks.
The needle being used to enter into the body has to break the surface of the skin and can thus carry with it certain micro-organisms into a sterile area. Doctors can use a pre-injection swab of chlorhexidine to prevent this from happening but there is a tiny chance that some infection will occur regardless.
Some amount of pain in the back, as well as the legs, can be expected after a spinal tap procedure has been performed. The reasons for this could be many starting from the dexterity and technique of the doctor to the individual pain threshold.
In most cases, a simple painkiller along with a cold compress should be enough to take care of the pain.
Swelling And Bruising
Some amount of bleeding leading to bruising is also a common occurrence after a spinal tap has been performed. The minor trauma of the needle passing through the various tissues of the body may also cause some inflammation which can worsen the swelling, pain and overall discomfort in the area.
A course of over the counter anti-inflammatory drugs is enough to take care of the situation. If the swelling continues to get worse even after a couple of days then you should seek the attention of your doctor.
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