Lumbar puncture
Lumbar Puncture Key Points
- An LP should be performed at the L3/L4 or L4/L5 space as the spinal cord terminates at L1-L2
- The first 'give' of the needle is when the ligamentum flavum is pierced and the second 'give' is when the dura is pierced
- Normal opening pressure is between 10-25 cm H2O in an adult
- Post procedure headache is common (up to 38%)
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Layers pierced during lumbar puncture:
- Skin
- Subcutaneous tissue (fat and fascia)
- Supraspinous ligament
- Interspinous ligament
- Ligamentum flavum
- Extradural space
- Dura mater
- Subdural space
- Arachnoid mater
- Subarachnoid space