The spinal cord terminates about five inches above the site of the lumbar puncture needle insertion. There is essentially little risk of nerve injury or paralysis since the needle is put deep below where the spinal cord ends. The risks include infection and bleeding under the skin, but not paralysis.
Lumbar punctures are commonly performed in patients with neurological problems to test for infections, toxins, and cancer. This procedure is often done on an outpatient basis using local anesthesia. It requires the placement of a small needle into the lower back over the tailbone. The patient is asked to bend forward while the doctor inserts the needle into the space between the vertebrae at a right angle from above.
The fluid inside the brain and spinal cord can be tested for bacteria, viruses, proteins, and cells. The results of the test may help identify the cause of your symptoms and lead to treatments that will improve your quality of life.
Paralysis after a lumbar puncture usually occurs if the needle goes too far downward into the spine. Since the spinal cord terminates just above this level, there is very little risk of injuring it by going too far down. However, if the tip of the needle is left in place for more than 10 minutes, then this procedure should not be done again because more serious complications could arise.
However, you may experience pain during the procedure.
To avoid spinal cord damage, needle insertion under local anaesthesia needs precise placement. Because the spinal cord terminates as a solid structure at the level of the second lumbar vertebra (L2), the needle must be inserted below this point, generally between L3 and L4 (Fig 2). A puncture at higher levels may cause severe pain due to the presence of nerve roots in close proximity to the opening into the spinal canal.
Spinal needles are usually thin and long. They are made of stainless steel or plastic. The longer the needle, the less likely it is to go straight through skin or muscle and hit a major blood vessel or organ. The needle should be as thick as possible without being so heavy that you can't manipulate it easily. Generally, a spinal needle comes with two parts: a stylet, which is pushed into the back of the needle to keep it open, and a cannula, which is the needle's cutting edge. There are different types of spinal needles for different purposes. For example, a fine-gauge spinal needle is used for taking cerebrospinal fluid (CSF) samples. This type of needle has a small hole at its tip so that only a few drops of CSF are taken from the spine for testing. Coarser-gauge needles are used for injecting medications or performing other tasks near the spinal cord.
Serious problems from this surgery are quite uncommon. Because the spinal cord stops higher up, the spinal canal in the lower lumbar spine solely contains fluid. This implies that the spinal cord in the lumbar spine cannot be injured. It is likely that any damage would occur before it reached the spinal cord.
Spinal cords stop at different levels in everyone's spine. The lowest level of the spinal cord that can be affected by a lumbar puncture is L1-L2. A person's actual risk of developing serious complications after this procedure is very low if proper precautions are taken.
Damage to the spinal cord can happen when looking down a gun barrel. This is called a "gunshot wound". Looking down a gun barrel is what happens when you pull the trigger. The energy from the firing of the gun travels through the handle and into your hand. If the gun is not properly handled, this energy could travel up the gun shaft and injure your spinal cord.
A gunshot wound to the head is usually fatal. However, a spinal cord injury due to a gun accident can lead to permanent disability or death. These injuries may happen because someone was trying to protect themself by holding their head up high or keeping their back straight. They also may have been thrown forward or backward during the incident.
Lumbar punctures are often performed in hospitals, however some neurologists now do them as outpatient operations in their offices. A thin, hollow needle is inserted into the lower section of the lumbar spine, commonly between the third and fourth or fourth and fifth lumbar vertebrae. The needle is used to remove fluid for testing under microscopic examination by a neuropathologist.
The spinal cord begins at the bottom of the brain and continues all the way up to the neck. Any injury or disease that affects the spinal cord can cause pain, muscle weakness, loss of bladder or bowel control, even death. The nerves from the spinal cord branch out through openings in the bone called synapses, sending messages to other parts of the body when they are healthy. In cases of injury or disease, these nerves may be damaged causing pain, muscle spasms, poor reflexes, and sensory problems.
Many diseases affect the nervous system, including Alzheimer's disease, amyotrophic lateral sclerosis (ALS or "Lou Gehrig's disease"), multiple sclerosis, Parkinson's disease, and transverse myelitis. Other disorders include infections such as meningitis and HIV/AIDS-related dementia. Even normal aging can cause problems with thinking skills and judgment. A stroke results in damage to the blood vessels supplying the brain and sometimes causes paralysis on one side of the body.
While a spinal tap can be painful, the idea that it would result in paralysis is baseless. When the spinal cord, which extends from the brain stem to the top of the lumbar vertebrae and normally ends in the area between the first and second lumbar vertebrae, is injured, paralysis can ensue. However, a lumbar puncture performed in an appropriate setting should not cause any harm to the patient.
The most common complication of a lumbar puncture is a headache. Other possible complications include nausea, vomiting, changes in vision, feeling faint or dizzy, infection, bleeding at the site where the needle was inserted, allergic reaction to the dye used in the procedure, and fever.
Paralysis is a very serious complication that requires immediate medical attention. If you experience any loss of function in your body, call your doctor immediately.
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