Puncture of the spinal cord

Spinal puncture involves the introduction of a special needle into the subarachnoid space of the spinal cord. It is used for diagnostic or therapeutic purposes.

Puncture of the spinal cord is performed in special laboratories where the pressure of the CSF is measured and the patency of all spaces of the given organ is determined. It allows timely diagnosis of the presence and intensity of hemorrhage, determine the nature of stroke, identify inflammatory processes in the meninges, determine changes in cerebrospinal fluid that occur in diseases of the central nervous system. The magnitude of the pressure of the cerebrospinal fluid leads to a conclusion about this index in the fluid of the brain. Also spinal cord puncture is used to administer various medicinal and radiopaque substances, as well as radiopharmaceuticals, air during myelography, cisternography, pneumoencephalography.

For medical purposes, such manipulation is performed with the purpose of extracting a purulent or bloody liquid, for the administration of antiseptics, antibiotics. They are used for severe diseases of the purulent-inflammatory nature of the spinal cord and brain.

Puncture of the spinal cord occurs between the spinous processes of the third and fourth lumbar vertebrae. At the same time, all the rules of antiseptic are observed: they treat the skin with a solution of iodine, then wipe the site of the injection with alcohol. Anesthesia is also performed, for which a novocaine solution is used. Only after this, a puncture needle is inserted, at the end of which a mandril is attached. After piercing all tissues, a characteristic dip is observed, which indicates the entry into the epidural space. After that, remove the mandrake and make sure of the flow of cerebrospinal fluid. When observing the rules, manipulation is safe.

Puncture of the spinal cord has the following indications: spontaneous hemorrhages in the subarachnoid space due to rupture of aneurysms, meningoencephalitis, meningitis, myelitis, arachnicelitis, cysticercosis, echinococcosis, neurosyphilis, liquorrhea, craniocerebral trauma. It is also used for the administration of antibiotics for tuberculous meningitis, purulent meningoencephalitis. Sometimes, when performing operations on the brain, puncture of the spinal cord is used to reduce the parameter of intracranial pressure, to facilitate access to malignant tumors.

With volumetric formations in the central nervous system, this method is used with caution, as with a decrease in pressure, the tumor can change its location and become trapped in the large occipital or tentorial aperture. In comatose conditions, spinal cord puncture is also used. The consequences of its improper conduct can become fatal, especially in pathological conditions with unknown etiology.

Other complications of this procedure: meningism, which manifests itself as shell symptoms, headache and unpleasant sensations in the lumbar region, vomiting, nausea. The hole that forms after manipulation may remain open for a long time, resulting in hypotension. Repeated spinal punctures lead to the appearance of cholestat implantation in the canal of the spine. But the most dangerous complication is the infringement of the brain stem. Such puncture can lead to death. By the number of complications it is second only to bone marrow puncture , the consequences of which are the development of anemia, osteomyelitis. Therefore, compliance with the rules is a priority in conducting such diagnostic operations.