On the importance of posture: the optimal sitting position for lumbar puncture

It is well known that the most common complications of lumbar puncture (LP) are post-puncture low back pain and post-puncture headache (PLPH). According to related reports [2], low back pain, headache and typical PLPH after LP account for 17%, 19%, and 9%, respectively. Complications after LP are mostly related to the patient's history of headache, fear, type of puncture needle, patient's position before and after puncture, and the number of punctures.

Lumbar puncture in the lateral decubitus position and sitting position are rare or unknown in China. The issues we are most worried about are pressure measurement, the possibility of brain herniation and postoperative headaches.

Let's take a look at the consensus guidelines for lumbar puncture in neurological diseases formulated by a foreign expert group of neurology experts in May 2017 [2]: in the sitting position, the patient should fully bend the neck and back to expand the adjacent lumbar intervertebral space to facilitate needle insertion. The optimal puncture position depends on the clinical situation of the physician and the patient

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