neurologic disorders
How To Do Lumbar Puncture
Warnings and Common Errors
Be sure to keep the patient's hips, back, and shoulders precisely perpendicular to the bed. When using the lateral decubitus position, maintain the patient's tightly curled fetal position. Be sure to direct the needle toward the midline (not angled to one side) and slightly cephalad. These errors make it difficult to enter the spinal canal. Do not withdraw the needle without reinserting the stylet. If the spinal canal is not entered, do not try to reposition the needle by moving the tip to one side or another; this can damage tissue. Instead, withdraw the needle nearly to the skin surface (ie, outside of the spinal ligament) before changing the angle and direction of insertion. 