Spinal Tap - Lumbar Puncture

In a spinal tap or lumbar puncture, a small sample of the cerebrospinal fluid that surrounds the spinal cord is first withdrawn with the help of a needle and is then examined in a lab. A patient suffering from multiple sclerosis will generally have elevated levels certain proteins, antibodies and breakdown products of Myelin in the cerebrospinal fluid. The lumbar puncture is very helpful in diagnosing multiple sclerosis in many people, but it is no longer considered to be a mandatory test in every instance.

Spinal taps are also performed for a number of other reasons, like looking for any signs of infection, measuring the pressure around the spinal cord and brain, or even injecting dye for one of those X-ray diagnostic tests. People suffering from multiple sclerosis may sometime shave medications like Baclofen that will be injected via lumbar puncture.

Before taking the test, it is important to maintain a standard yet regularized eating schedule. There should be no fluid or dietary restrictions before the test. But, it would be wise to consult with your doctor for specific rules and regulations and guidelines about stopping alcohol use, anticoagulant medications or aspirin products before the test is taken. And, if you are allergic to Novocaine or Betadine, make sure you tell your doctor this.

Also, it is very important to make arrangements for transport beforehand, as you are not recommended to drive your vehicle immediately after taking the test.

During the spinal tap, you will be made to lie down on your side with your knees pulled as close to your chest as possible and your chin resting on your chest, or you will either be made to sit with your head and arms resting on a table. Once that area of the skin is cleaned off with antiseptic, sterile cloths that are also known, as drapes will be placed on that area. Next, you will be injected with a local anesthetic and it is possible that you will feel a mild burning sensation. Once the area turns numb, a hollow needle will then be inserted into your lower back, right between the two lumbar vertebrae. This can also cause a lot of pressure.

The spinal canal will then be penetrated and the fluid will be withdrawn or the medication will be injected. During the test, the needle will not touch the spinal cord at all. There are chances that you might feel some slight discomfort or you might have a mild headache. Once the fluid is removed or the medication injected, the needle will then be removed. Once this is done, the area will be cleaned once again with antiseptic and then covered with a bandage. You will then be made to lie on your stomach or back for about an hour.

A blood sample will then be taken from one of the veins in your arm and will go in for testing, along with the spinal fluid collected. The blood sample wont necessarily be taken, especially if the procedure involves injecting medication.

Around 10 to 20 percent of the people who have taken the test develop a spinal headache that worsens when standing or sitting, and this is generally caused due to the lumbar puncture. The risk of infection however is very low and occasionally, in a few rare cases, a small blood vessel may be pierced causing a slight bloody discharge, but this is not serious and no treatment is required. This procedure is generally not painful, but there may be some momentary twinges of pain if the needle happens to brush against nervous tissue.

One the test is taken; the patient will be monitored for about an hour. A nurse will discuss some of the post-procedure instructions with the patient and will then probably give the patient written instructions as well.