About Your Lumbar Puncture

This information will explain your lumbar puncture procedure at Memorial Sloan Kettering (MSK).

A lumbar puncture, also called a “spinal tap” or an “LP,” is a procedure that is done to get a sample of fluid called cerebrospinal fluid (CSF). This is the fluid that surrounds your brain and spinal cord.

Your healthcare provider may need to take a sample of your CSF in order to check for problems, such as:

  • An infection, such as meningitis
  • Bleeding
  • Cancer that has spread to the tissues surrounding your brain or spinal cord

Your healthcare provider may also do a lumbar puncture to give certain types of medication directly into the area surrounding your spinal cord. These medications may be:

  • Anesthesia to block pain
  • Cancer-fighting medications (i.e., chemotherapy)
  • Antibiotics

Before Your Procedure

Tell your healthcare provider if you are:

  • Allergic to iodine (Betadine®).
  • Sensitive or allergic to any adhesives such as tape.
  • Taking any blood thinners. Some examples of blood thinners are heparin, warfarin (Coumadin®), clopidogrel (Plavix®), enoxaparin (Lovenox®), and tinzaparin (Innohep®). There are others, so be sure your doctor knows all the medications you’re taking.
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The Day of Your Procedure

Where to park

There are garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, East 65th Street between First and Second Avenues, and East 65th Street between Second and Third Avenues.

Where to go

Check your appointment reminder for information on where to go.

Many lumbar punctures take place at the 64th Street Outpatient Center. It is located at 205 East 64th Street, between Second and Third Avenues.

What to expect

You will either be lying on your side and hugging your legs, or sitting upright and leaning over a table so that your back is curved in a “C” shape. It is very important to stay still during the procedure.

Your nurse will clean the area around your lower back with Betadine. He or she will inject numbing medication (anesthesia) into the area so that you will not feel any pain.

Your healthcare provider will gently insert a needle between 2 of the bones in your spine (vertebrae) and into the space filled with CSF. The CSF will drip out of the needle and your doctor or nurse will collect it in a vial. If you will be getting medication into your spinal cord during the procedure, this will happen after the fluid is removed.

A bandage (Band-Aid®) will be placed on the area where the needle was inserted.

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After Your Procedure

At the hospital

You may be asked to lie flat on your back for up to 30 minutes.

At home

You can remove the bandage the day after your procedure.

Side effects

Sometimes people can get a headache after having a lumbar puncture. This happens because the spot where the needle goes in does not always close up right away. If the hole stays open, CSF can leak out, causing a headache.

In most cases, the hole will close up on its own and the headache will go away in 1 to 2 days.  You can take over-the-counter pain medication for the headache, such as acetaminophen (Tylenol®) or ibuprofen (Advil®). Lying down may also make you feel better

Caffeine can also help to reduce headaches. One 8-ounce cup of coffee has about 150 milligrams of caffeine. You can try drinking 1 to 2 cups of coffee per day to relieve your headache.

If your headache does not improve within 2 to 3 days, call your doctor. He or she may give you a treatment called a “blood patch.” This involves taking a small amount of your blood and injecting it into the area where the LP was performed. The blood will fill the hole and the headache will go away.

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Call Your Healthcare Provider if You Have:

  • Any signs of infection at the site. Signs of an infection are redness, swelling, discharge at the site, and a temperature of 101º F (38.3º C) or higher.
  • Bleeding at the site.
  • Pain or numbness in your back or legs.
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