RT Journal Article
SR Electronic
T1 Difficult Lumbar Puncture: Pitfalls and Tips from the Trenches
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1276
OP 1283
DO 10.3174/ajnr.A5128
VO 38
IS 7
A1 Hudgins, P.A.
A1 Fountain, A.J.
A1 Chapman, P.R.
A1 Shah, L.M.
YR 2017
UL http://www.ajnr.org/content/38/7/1276.abstract
AB SUMMARY: Lumbar puncture has, for many years, been the responsibility of the internal medicine physician or the neurologist. As more patients have undergone spine surgery and with the current increase in body mass index of the general population, the radiologist has been consulted with increasing frequency to perform lumbar puncture with fluoroscopic guidance. Radiology, in fact, is now the dominant overall provider of lumbar puncture procedures. The procedure is more difficult when the needle length increases, and if fluoroscopy is used, landmarks are more difficult to visualize with increasing subcutaneous fat. Our goal with this review was to describe our techniques for lumbar puncture in the difficult patient, with emphasis on using fluoroscopy in the obese patient and to suggest maneuvers that might make the procedure easier. Combining our experience from performing these procedures on an obese population, we would like to share our tips, especially with trainees early in their career.BMIbody mass indexIIHidiopathic intracranial hypertensionLPlumbar puncture