Reasons you may not be able to
have the biopsy or why the results may not be helpful include:
Not being able to lie still during the
Having conditions such as
dehydration, spinal disease, severe
arthritis, or recent spinal surgery. These conditions
may make it hard to do a lumbar puncture with the person lying down. The
procedure may need to be done with the person sitting up and bent forward. In
some cases, the procedure may need to be done with a special X-ray method
fluoroscopy. This is used to guide the placement of
the spinal needle.
Bleeding into the cerebrospinal fluid (CSF). The
needle puncture can cause bleeding into the CSF. Several samples of the fluid
can show the difference between bleeding from the puncture and bleeding caused
by a brain hemorrhage.
Not being able to collect a sample of the
fluid. This is called a "dry tap."
infection on the lower back. Doing a lumbar puncture in this case may allow the
infection to spread into the spinal canal.
which may increase the chance of bleeding during the procedure.
Other tests that may be done include:
A cisternal or ventricular puncture.
Cerebrospinal fluid (CSF) can be collected from the upper spinal canal at the
base of the skull (cisternal puncture) or from within the skull (ventricular
puncture) when it is not possible to get CSF from the lumbar area. These
procedures are done by a trained
radiologist or neurosurgeon. Special X-ray methods are
used to guide the placement of the needle.
studies. In cases of suspected bacterial meningitis, bacterial marker
(bacterial antigen) studies can quickly find the common types of bacteria that
cause meningitis. Antibiotic treatment for that bacteria can be started
Fischbach FT, Dunning MB III, eds. (2009).
Manual of Laboratory and Diagnostic Tests, 8th ed.
Philadelphia: Lippincott Williams and Wilkins.
Other Works Consulted
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.