Position and operation of the lumbar puncture needle

Before the lumbar puncture operation, the doctor will communicate with the child gently to eliminate the child’s fears. Under the condition that the child can cooperate, start the next lumbar puncture operation:

The patient lies on a hard board bed with the back perpendicular to the bed surface, the head is bent forward and the chest is bent, and the knees are tightly attached to the abdomen with both hands, so that the torso is arched; or the assistant holds the patient’s head with one hand and the popliteal with the other hand opposite the surgeon Hold the socket tightly to make the spine as kyphotic as possible to widen the intervertebral space and facilitate needle access.

The doctor will ask the child to take a side-bending position, and ensure that the back is perpendicular to the bed surface to facilitate the identification of the marking points. Usually the doctor will choose the lumbar 2 to sacral 1 (mainly lumbar 3-4) intervertebral puncture;

After setting up the position and determining the puncture point, put on sterile gloves, perform local routine disinfection and anesthesia;

Make sure to puncture slowly in the correct direction. If the needle tip encounters bone during the needle insertion process, the doctor will retract the needle under the skin and correct the angle before performing the puncture. Usually when the needle is about 4-6cm in adults (about 3-4cm in children), it can penetrate the dura mater and reach the subarachnoid space;

Withdraw the needle core and flow out the cerebrospinal fluid. After measuring the cerebrospinal fluid pressure and collecting the cerebrospinal fluid sample, pull out the puncture needle;

The puncture point is pressurized to stop bleeding, covered with sterile gauze and fixed with tape. Lie supine for 4-6 hours after operation;

The collected cerebrospinal fluid is sent to the laboratory for testing.

The whole waist piercing process can be completed in about 10 minutes if it is smooth. Except for the slight pain when taking anesthetics, most children will not feel obvious discomfort.

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