Spinal Cord Termination and Lumbar Puncture Safety in Spinal Deformities

Background Lumbar puncture, a common diagnostic and therapeutic procedure, is performed regardless of individual spinal alignment variations. However, the impact of kyphosis, scoliosis, and kyphoscoliosis on spinal cord termination level and lumbar puncture safety remains unclear. Objectives This study aimed to determine if the termination level of the spinal cord is different in individuals with spinal deformities and to assess the necessity of routine neuroimaging for safe lumbar puncture localization. Study design and settings This single-center retrospective study was conducted at a university hospital using patients' electronic medical records. The study was focused on patients diagnosed with kyphosis, scoliosis, or kyphoscoliosis using spinal magnetic resonance imaging from January 2010 to December 2022. Participants We evaluated 240 patients: 120 with diagnosed spinal deformities (kyphosis, scoliosis, or kyphoscoliosis) and 120 without deformities, categorized by sex (deformed: 92 females, 28 males; non-deformed: 72 females, 48 males). Patients with spinal trauma, bleeding, or tumors were excluded. Results No statistically significant correlation was found between spinal deformities and spinal cord termination, with L1 remaining the most common endpoint in all groups. Conclusion Routine neuroimaging prior to lumbar puncture in patients with spinal deformities was not associated with a safer procedure due to no observed impact on the termination level of the spinal cord.