An evaluation of the practice of image guided lumbar puncture

Link to article at PubMed

Br J Radiol. 2023 Apr 17:20220143. doi: 10.1259/bjr.20220143. Online ahead of print.


OBJECTIVE: The purpose of this study was to evaluate the technical success and complication rates of image guided lumbar puncture (IGLP) and to evaluate for differences in approach employed to help establish the optimum technique.

METHODS: A retrospective search of the hospital picture archiving and communications system was performed to identify all IGLPs that had taken place over a 5 year period. Radiology reports and the electronic medical record were examined to identify technical parameters and complications associated with each procedure.

RESULTS: The technical success rate was 96% (219/228). 69.4% (n = 161) had a previously failed bedside attempt. The rate of complications was 0.01% (n = 2).No major complications were observed. There was no difference in the rates of failure (2.4% vs 3.6%, p = 0.68) or complications (0.008% vs 0.012%, p = 1) between interlaminar and interspinous approaches.

CONCLUSION: IGLP is a safe procedure with a high rate of technical success. Where a difficult bedside attempt is anticipated, it is reasonable to forego this and proceed directly to IGLP.

ADVANCES IN KNOWLEDGE:: This paper helps to confirm what is already assumed about a common radiological procedure. This is important as there has been a shift from bedside technique to most lumbar punctures being performed via image guidance.

PMID:37066810 | DOI:10.1259/bjr.20220143

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