lumbar puncture needle landmark

Draw a line between the upper borders of the iliac crests on both sides, intersecting the midline passing through the L4 spinous process. Insert the needle in the space between L3 and L4 or L4 and L5, as these points are located below the terminal segment of the spinal cord. Physicians should look for landmarks before sterilizing the skin and injecting local anesthetic, as these operations have the potential to obscure the landmarks. Use a skin marker to mark the correct location.

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