A controlled lumbar puncture procedure improves the safety of lumbar puncture

Chun Li; Miaomiao Li; Yixian Wang; Shaoyi Li; Lin Cong; Weining Ma

doi:10.3389/fnins.2023.1304150

A controlled lumbar puncture procedure improves the safety of lumbar puncture

Front Neurosci. 2023 Dec 5:17:1304150. doi: 10.3389/fnins.2023.1304150. eCollection 2023.

Authors

Chun Li¹, Miaomiao Li², Yixian Wang³, Shaoyi Li², Lin Cong⁴, Weining Ma²

Affiliations

¹ Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
² Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China.
³ Department of research and development, Medimicro (Tianjin) Medical Device Co., LTD, Tianjin, China.
⁴ Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China.

Abstract

Background: In order to improve the safety of lumbar puncture (LP), we designed a new type of LP needle, that is, an integrated and controlled LP needle, which can actively and accurately control the flow rate and retention of cerebrospinal fluid (CSF) during puncture, so as to achieve a controlled LP procedure.

Objective: To evaluate whether a controlled LP procedure can improve the comfort of LP and reduce the risk of complications associated with LP.

Methods: Patients requiring LP (n = 63) were pierced with an integrated and controlled LP needle or a conventional LP needle. The differences in vital signs, symptom score, comfort, operation time, CSF loss, CSF pressure fluctuation and back pain before and after puncture were analyzed.

Results: An integrated and controlled LP needle (n = 35) significantly improved patients' headache symptoms before and after puncture. In addition, a controlled LP procedure significantly reduced the amount of unnecessary CSF loss (p < 0.001), shortened the time of puncture (p < 0.001), improved patient comfort (p = 0.001) and reduced the incidence of back pain (p < 0.001). For patients with high intracranial pressure (HICP), the fluctuations in pressure of the CSF were also reduced while obtaining similar amounts of CSF (p = 0.009).

Conclusion: A controlled LP procedure avoids unnecessary CSF loss, prevents rapid fluctuations in CSF pressure in patients with HICP, and reduces the risks associated with LP.

Keywords: high intercranial pressure; lumbar puncture; post-dural puncture headache; puncture needle; the CSF opening pressure.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.