Complications of lumbar puncture needles

Defining the boundaries of obesity can be challenging for physicians. Osteoarthritis, ankylosing spondylitis, kyphoscoliosis, a history of lumbar surgery, and degenerative disc disease may make lumbar puncture difficult to complete. For patients with such disorders, a consultation with an anesthesiologist or interventional radiologist may be required to improve the success rate of lumbar puncture. Complications of lumbar puncture include cerebral hernia, impaired cardiopulmonary function, local or referred pain, headache, bleeding, infection, subarachnoid epidermal cysts, and CSF leakage. The most common complication was headache, which occurred in 36.5% of patients within 48 hours of lumbar puncture. The reason for the headache is that CSF leaks from the puncture site faster than CSF is produced. The increased incidence of headache was related to the thickness of the lumbar puncture needle used. The most serious complication is herniation of the brain, which can occur if the pressure difference between the cranial cavity and the spinal cavity is large. This pressure difference can increase during lumbar puncture, resulting in the formation of a brainstem hernia. Through detailed medical history and neurological physical examination, physicians can find patients at high risk of cerebral hernia. If the physician is still concerned about performing a lumbar puncture, CT may be helpful, but elevated intracranial pressure may not always be detected by imaging. However, not all patients need CT because it can delay diagnosis and treatment. Patients with hemorrhagic quality are particularly prone to bleeding, which can cause compression of the spinal cord. There is no absolute standard for the relationship between the degree of coagulation disorder and the risk of bleeding, so the physician must make a clinical judgment. Subarachnoid epidermal cyst is caused by skin embolus entering subarachnoid cavity, and the puncture needle with needle core can avoid its occurrence.

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