Lumbar Puncture

A lumbar puncture, also known as a spinal tap, is performed to collect a small sample of cerebrospinal fluid (CSF). CSF is the fluid that circulates in your spinal column and the base of the skull to protect your brain and spinal column from injury.

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For patients with acute lymphocytic leukemia (ALL), a sample of CSF is analyzed for signs that the cancer has spread to the spinal column or the brain. In some cases, a lumbar puncture may be used to administer chemotherapy to prevent or treat leukemia that has spread to the spinal column or brain.

A lumbar puncture involves inserting a small needle between the bones of the spine in the lower back to collect the sample. The procedure usually lasts about 45 minutes. It is important to lay as still as possible during this somewhat uncomfortable procedure to minimize the risk of side effects or complications.

During the procedure, the patient lies on his side with knees drawn up to the chest in the fetal position. The procedure starts with injecting a local anesthetic in the lower spine to lessen the discomfort. The doctor may recommend a general anesthetic for children who might have trouble lying still for the length of the procedure. The doctor will then insert a needle into the spinal column and withdraw a sample of the CSF. The sample will be analyzed in the laboratory to look for leukemia cells, white blood cell count, and signs of infection. After the procedure, the patient is required to lie flat for 20 minutes to one hour.

The most common complications are headache and nausea, which can usually be relieved with bed rest. Serious complications of a correctly performed lumbar puncture are rare. The primary risk for patients with leukemia is that blood will leak into the spinal column, which can provide a pathway for leukemia cells to enter the spinal column. For this reason, it is important to seek out an expert in this procedure.