E2027. The Fluoroscopic Guided Lumbar Puncture: An Overview
  1. Veer Gariwala; Eastern Virginia Medical School
  2. Dan O'Neal; Eastern Virginia Medical School
  3. John Agola; Eastern Virginia Medical School
The fluoroscopic guided lumbar puncture is a common procedure to perform; however, getting to that point involves a multitude of steps. We aim to review all the steps required to perform a successful lumbar puncture starting from when the order prints off to finally sending off the cerebrospinal fluid for lab analytics. Though this is considered a simple procedure, the lumbar puncture has many obstacles which can arise during the procedure and we shall go over what these are and how to effectively solve them.

Educational Goals / Teaching Points
To review indications and contraindications of a lumbar puncture. To explain the various initial patient positions. Go through the descriptions and appropriate usage of items included within a standard lumbar puncture kit. Review of various needle types. Outline all the steps to perform a successful lumbar puncture. Highlight opening and closing pressure techniques most accessible in the fluoroscopic setting. Review of literature for alternative OP techniques. Go over cerebrospinal fluid collection requirements. Teach how to properly terminate the procedure and review of potential complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will examine lumbar punctures specifically done under fluoroscopy. This exhibit will show images of what proper patient positioning should look like along with the relevant fluoroscopic image. Photographs will be shown of the different elements contained within a lumbar puncture kit. Fluoroscopic images with needle positioning and appropriate sites of needle entry will also be shown.

This exhibit will go over key steps in the pre-procedure preparation, positioning, procedural technique, complications, and tricks to successfully complete a fluoroscopic guided lumbar puncture.