You can take this off this the next day.Ī lumbar puncture takes about half an hour. The doctor then removes the needle and puts a plaster or dressing on your skin.If you are having intrathecal chemotherapy, the doctor injects drugs into your spinal canal through the lumbar puncture needle.The doctor collects a small amount (usually around one teaspoonful or 5 ml) in sterile tubes. When the needle is in the right place, CSF starts to drip out.The doctor inserts the needle at a level that is much lower than your spinal cord so your spinal cord can’t be damaged. The needle enters the spinal canal, which is filled with cerebrospinal fluid (CSF). You might experience a feeling of pressure in your back. When the area is numb, the doctor inserts a thin needle into the gap between two bones in your lower spine.The doctor then injects local anaesthetic into the skin of your lower back. When you are in the correct position, the doctor cleans your lower back with antiseptic and places a sterile cover over your body.The doctor uses real-time X-rays of your spine, displayed on a computer monitor, to help them find the best place to perform the lumbar puncture.įigure: Lumbar puncture needle going into the lower spine For this, you lie on your front or side on an X-ray table. In this case, your doctor might recommend an ‘X-ray guided’ lumbar puncture. Very rarely, a lumbar puncture might be technically difficult (for example, if you have curvature of the spine, or if you are obese). Make sure you are comfortable – you need to keep as still as possible during the procedure. In this case, you are asked to sit leaning forwards onto a pillow that is resting on a table in front of you. Sometimes, you might need to sit up instead. To have a lumbar puncture, you usually lie on your side and curl up, with your knees pulled up towards your chest. What happens during the procedure?īefore you have a lumbar puncture, the doctor explains what it involves and asks you to sign a consent form. If you usually have medicine to thin your blood, your medical team might ask you to stop taking it a few days before the procedure to reduce your risk of bleeding. Tell your medical team about any medicines, vitamins and other supplements you are taking. You can eat and drink as normal before the test. You might have a blood test before the procedure to check that you don’t have any problems with blood clotting. You should be given information about the procedure and how to prepare for it. Most people who need a lumbar puncture have the procedure as an outpatient and do not have to stay in hospital overnight. Having the chemotherapy through a lumbar puncture can help the drugs reach your brain and spinal cord. This might be the case if you have CNS lymphoma, or if your medical team think you are at high risk of your lymphoma spreading to your CNS. You might also need a lumbar puncture if your medical team thinks you would benefit from having chemotherapy injected directly into the fluid around your brain and spinal cord ( intrathecal chemotherapy). Your medical team decides what tests you need based on your individual circumstances. Most people with these types of lymphoma do not develop lymphoma in their central nervous system and not everyone with these types of lymphoma needs a lumbar puncture. This happens occasionally with some types of high-grade non-Hodgkin lymphoma, such as: The lymphoma might begin in your central nervous system (primary CNS lymphoma) or it might spread there from elsewhere in your body (secondary CNS lymphoma). This is called central nervous system (CNS) lymphoma. You might need a lumbar puncture if your specialist suspects that you have lymphoma in your brain or spinal cord. Sometimes a lumbar puncture is used to give medicines into the fluid around your brain and spinal cord, through an injection into your lower back. They might also run specialised tests on the sample. A specialist doctor called a pathologist examines the fluid sample under a microscope to see if it contains any lymphoma cells. It is usually done to take a sample of the fluid that cushions your brain and spinal cord for testing (a ‘diagnostic’ lumbar puncture).
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