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Related Experiment Video

Updated: May 25, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
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Practice patterns and opening pressure measurements using fluoroscopically guided lumbar puncture.

A S Abel1, J R Brace, A M McKinney

  • 1Departments of Ophthalmology, University of Minnesota, Minneapolis, Minnesota, USA.

AJNR. American Journal of Neuroradiology
|January 24, 2012
PubMed
Summary

Most neuroradiologists use similar techniques for fluoroscopically guided lumbar puncture (LP), but measurement methods for opening pressure (OP) vary significantly. A standardized protocol is needed for consistent and accurate OP measurements during LPs.

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Area of Science:

  • Radiology
  • Neuronscience

Background:

  • Evidence-based protocols for fluoroscopically guided lumbar puncture (LP) are lacking.
  • Current practices among practicing neuroradiologists for fluoroscopically guided LP were analyzed.

Purpose of the Study:

  • To analyze the fluoroscopically guided LP techniques used by practicing neuroradiologists.
  • To identify variations and inconsistencies in current LP procedures.

Main Methods:

  • An anonymous, web-based survey was distributed to members of the American Society of Neuroradiology (ASNR).
  • Responses were compiled and tabulated for analysis.

Main Results:

  • 577 neuroradiologists completed the survey.
  • Most perform fluoroscopically guided LPs in the prone position using a 22-gauge needle at L2-L3 or L3-L4.

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  • Opening pressure (OP) measurement techniques are highly variable, with few patients positioned in the left lateral decubitus (LD) position.
  • Post-procedure care typically involves 1-2 hours of observation and strict bed rest.

    • Conclusions:

    • Neuroradiologists exhibit consensus on thecal sac puncture techniques.
    • Normative adult OP data are limited to the LD position; prone OP measurement accuracy is unknown.
    • Inconsistent OP measurement techniques highlight the need for a standardized protocol.