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Computed Tomography-Guided Lumbar Puncture: Advantages and Disadvantages
İzzet Ökçesiz1, Halil Dönmez1, Nevzat Herdem1
1From the Departments of Radiology.
Journal of Computer Assisted Tomography
|January 26, 2022
Summary
Computed tomography (CT)-guided lumbar puncture (LP) is effective for patients with prior failed attempts. This imaging guidance offers a viable alternative for challenging LP procedures, demonstrating good technical success rates without major complications.
Area of Science:
- Neurology
- Radiology
- Interventional Procedures
Background:
- Lumbar puncture (LP) is a common diagnostic and therapeutic procedure.
- Difficult LPs, especially those with a history of failed blind attempts, pose significant clinical challenges.
- Imaging guidance can potentially improve success rates and safety in these cases.
Purpose of the Study:
- To evaluate the effectiveness of computed tomography (CT) guidance for lumbar puncture (LP) in patients with a history of at least one unsuccessful blind attempt.
- To identify potential advantages and disadvantages of using CT guidance for difficult LPs.
Main Methods:
- A retrospective review of 32 CT-guided LP procedures performed between June 2019 and March 2021.
- Recording of all indications for LP procedures.
- Defining "primary technical success" as cerebrospinal fluid flow with a single puncture and "secondary technical success" as requiring additional punctures.
Main Results:
- Intrathecal nusinersen injections for spinal muscular atrophy were the most frequent indication.
- Primary technical success rate was 78.12%, and secondary technical success rate was 28.57% among the 32 procedures.
- No major procedural complications were reported.
Conclusions:
- CT-guided LP is an effective interventional technique for managing difficult lumbar puncture procedures.
- It serves as a valuable alternative approach when blind attempts have failed.
- The technique demonstrates a favorable safety profile with no major complications observed.
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