Lumbar Puncture

A lumbar puncture (may also be called a spinal tap), is a procedure used to collect a sample of cerebrospinal fluid (CSF).

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What is a lumbar puncture?

A lumbar puncture (may also be called a spinal tap), is a procedure used to collect a sample of cerebrospinal fluid (CSF). This is the fluid that protects and cushions your brain and spinal cord. The sample of CSF will be examined to see if there are any lymphoma cells present. In addition, other tests may be done on the sample of CSF which will provide the doctors with important information.

Why do I need a lumbar puncture?

A lumbar puncture may be needed if the doctor suspects that the lymphoma is affecting the central nervous system (CNS). A lumbar puncture may also be needed in order to receive chemotherapy directly into the CNS, known as intrathecal chemotherapy. This may be to treat lymphoma of the CNS. It may also be given as CNS prophylaxis. CNS prophylaxis means that the doctors are giving the patient preventative treatment as there is a high risk the lymphoma may spread to the CNS.

What happens before the procedure?

The procedure will be fully explained to the patient and it is important that everything is understood and any questions are answered. A blood test may be needed prior to the lumbar puncture, to check that the blood counts are satisfactory and that there are no issues with blood clotting. In most cases patients will be able to eat and drink normally before the procedure but the doctors will need to know what medication is being taken as certain medications such as blood thinners may need to be stopped prior to the procedure.

What happens during the procedure?

The doctor performing the procedure will need to access the back of the patient. The most common position to be in for this is to lie on your side with knees curled up to the chest. Sometimes this is difficult so it may be easier for some patients to sit up and lean forward onto a pillow that is resting on a table in front of you. Being comfortable is especially important as you will need to stay still during the procedure.

The doctor will feel the back to find the correct place to insert the needle. They will then clean the area and inject a local anaesthetic (to numb the area). When the area is numb the doctor will carefully insert a needle between two vertebrae (bones of the spine) in the lower back. Once the needle is in the correct place the cerebrospinal fluid will drip out and will be collected. It does not take very long to get the sample.

For patients who are having a Intrathecal chemotherapy, the doctor will then inject the medicine through the needle.

Once the procedure is complete the needle will be removed, and a dressing placed over the tiny hole left by the needle.

What happens after the test?

In most cases the patient will be asked to lie flat for a while after the lumbar puncture. During this time, blood pressure and pulse will be monitored. Lying flat will help prevent getting a headache, which can happen after having a lumbar puncture.

Most people can go home the same day but patients are not allowed to drive for 24 hours following the procedure. Post instructions will be provided to help with the recovery time and it is a good idea to try and drink plenty of liquids after the procedure as this may help to reduce headaches.

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