– A spinal tap, also known as a lumbar puncture, is a medical procedure that involves inserting a needle into the lower back to collect a sample of cerebrospinal fluid (CSF). CSF is the clear fluid that surrounds and protects the brain and spinal cord.

– A spinal tap can be used for various purposes, such as:

i). Diagnosing infections, inflammation, bleeding, cancers, or other disorders of the central nervous system. Some of the diseases that require a spinal tap for diagnosis are: meningitis, encephalitis, subarachnoid hemorrhage, multiple sclerosis, Guillain-Barre syndrome, and Alzheimer's disease.

ii). Measuring the pressure of the CSF, which can help diagnose conditions such as: pseudotumor cerebri, a disorder that causes increased pressure around the brain

iii). Injecting spinal anesthetics, chemotherapy drugs, or other medications into the CSF, which can help treat certain conditions such as cancer, spasticity, or pain.

iv). Injecting dye or radioactive substances into the CSF, which can help create diagnostic images of the fluid's flow, such as myelography or cisternography.

– A spinal tap is usually performed by a doctor or a nurse practitioner, under local anesthesia or sedation. The procedure takes about 15 to 30 minutes and involves the following steps:

• The patient lies on their side or sits and leans forward, with their back exposed.

• The doctor cleans the skin with an antiseptic and covers the area with sterile drapes.

• The doctor injects a local anesthetic into the skin and tissues of the lower back, which may cause a slight burning sensation.

• The doctor inserts a hollow needle between two lumbar vertebrae, into the space where the CSF is located. The doctor may use X-ray guidance to help locate the correct spot.

• The doctor collects a small amount of CSF in a syringe or a tube, or injects a medication or a dye into the CSF.

The patient may feel some pressure or discomfort during this step.

• The doctor removes the needle and covers the puncture site with a bandage.

• The patient lies flat for a few hours to prevent leakage of CSF and reduce the risk of headache.

– A spinal tap is generally a safe procedure, but it may have some risks and side effects, such as:

1). Post-lumbar puncture headache

– A common and usually mild complication that occurs when CSF leaks from the puncture site, causing low pressure in the CSF. The headache typically starts several hours to two days after the procedure and is worse when sitting or standing. It may be accompanied by nausea, vomiting, and dizziness. The headache usually resolves within a week with rest, hydration, and painkillers.

2). Back pain or discomfort

– Which may occur at the puncture site or radiate to the legs. It usually improves with rest, ice, and painkillers.

3). Bleeding

– Which may occur near the puncture site or in the epidural space, the area between the spinal cord and the vertebrae. Bleeding may cause bruising, swelling, or nerve damage. It may require surgery to stop the bleeding and relieve the pressure.

4). Infection

– Which may occur at the puncture site or in the CSF, causing fever, chills, redness, or drainage. Infection may require antibiotics or surgery to treat.

5). Brainstem herniation

– Which is a rare but serious complication that occurs when the brain shifts downward due to low pressure in the CSF. This can compress the brainstem, which controls vital functions such as breathing and heart rate. Brainstem herniation can cause loss of consciousness, coma, or death. It may require emergency surgery to relieve the pressure.

– A spinal tap can provide valuable information and treatment for various conditions affecting the brain and spinal cord. However, it is not a routine test and it is not without risks. Therefore, it should only be performed when the benefits outweigh the potential harms, and when the patient has given informed consent.

Preparing for a Spinal Tap

– A spinal tap, is a delicate procedure and before and after it's done, various guidelines should be adhered to to make sure you are not affected negatively in any way.

– To prepare for a spinal tap, you should follow these steps:

i). Drink plenty of fluids before the procedure, but avoid eating or drinking anything for three hours before the procedure.

ii). Tell your doctor if you have any allergies, especially to latex or any medications.

iii). Tell your doctor if you are pregnant or may be pregnant, or if you have any bleeding or clotting disorders.

iv). Tell your doctor if you are taking any medications, especially blood thinners, aspirin, or anti-inflammatory drugs. You may need to stop taking them before the procedure.

v). Bring someone with you to the procedure, as you will not be able to drive for 24 hours after the procedure.

vi). Bring any previous imaging tests of your spine or brain, such as X-rays, CT scans, or MRI scans, to the procedure.

– A spinal tap is usually a safe and effective procedure, but it may have some risks and side effects, such as headache, back pain, bleeding, infection, or brainstem herniation. You should follow the instructions of your doctor and nurse after the procedure, and contact them if you have any questions or concerns.

▶️ Can I drive after a spinal tap? How long does a spinal tap take? What should I expect after a spinal tap?

i). You should not drive right after a spinal tap, as you may feel dizzy or tired. You should rest for the remainder of the day and drink plenty of fluids. You should also have someone with you to drive you home or to the hospital.

ii). A spinal tap usually takes about 15 to 30 minutes, but you may need to stay in the hospital or clinic for a few hours after the procedure. Your doctor will check your blood pressure, pulse, and puncture site. They will also give you instructions on how to take care of yourself.

iii). After a spinal tap, you may experience some side effects, such as headache, back pain, or bleeding. These are usually mild and improve with rest, ice, and painkillers. However, if you have severe or persistent symptoms, such as fever, chills, redness, drainage, loss of consciousness, or difficulty breathing, you should contact your doctor or seek emergency care. These could be signs of a serious complication, such as infection or brainstem herniation.

Risks of Taking Spinal Tap

– A spinal tap as a procedure that involves the collecting of a sample of the cerebrospinal fluid from your lower back can be used to diagnose or treat various conditions affecting the brain and spinal cord. However, it also carries some risks, such as:

• Headache: This is the most common side effect, occurring in up to 25% of people who undergo a spinal tap. It is caused by fluid leaking from the puncture site, resulting in low pressure in the cerebrospinal fluid. The headache typically worsens when sitting or standing, and improves when lying down. It may also be accompanied by nausea, vomiting, and dizziness. It usually resolves within a week with rest, hydration, and painkillers.

• Back pain or discomfort: This may occur at the puncture site or radiate to the legs. It usually improves with rest, ice, and painkillers.

• Bleeding: This may occur near the puncture site or in the epidural space, the area between the spinal cord and the vertebrae. Bleeding may cause bruising, swelling, or nerve damage. It may require surgery to stop the bleeding and relieve the pressure.

• Infection: This may occur at the puncture site or in the cerebrospinal fluid, causing fever, chills, redness, or drainage. Infection may require antibiotics or surgery to treat.

• Brainstem herniation: This is a rare but serious complication that occurs when the brain shifts downward due to low pressure in the cerebrospinal fluid. This can compress the brainstem, which controls vital functions such as breathing and heart rate. Brainstem herniation can cause loss of consciousness, coma, or death. It may require emergency surgery to relieve the pressure.

– These risks are generally low and can be minimized by following the instructions of your doctor and nurse before and after the procedure. You should also contact them if you have any questions or concerns, or if you experience any severe or persistent symptoms.