IR( interventional radiology)-8

SPINAL PROCEDURES:-

Image source St. Mathew university school medicine by Dr. Mavrych, MD, PhD, DSc

1. Lumbar puncture
2. Myelogram
3. Spinal aspiration/ Intervertebral disc aspiration
4. Epidural/Subarachnoid/ Transluminal Injection
5. Facet joint injection
6. Transforaminal injection
7. Discogram
8. Vertebroplasty
9. Kyphoplasty

                                                            Lumbar Puncture:

Image source St. Mathew university school medicine by Dr. Mavrych, MD, PhD, DSc

What is a lumbar puncture (LP)?

A lumbar puncture (an LP) is that the insertion of a needle into the fluid within the vertebral canal.

Common names for lumbar puncture (an LP) include spinal tap, spinal puncture, thecal puncture, and rachiocentesis.

Why is a lumbar puncture done?

Image source St. Mathew university school medicine by Dr. Mavrych, MD, PhD, DSc

An LP is most commonly performed to diagnose a disease, namely to obtain a sample of the fluid in the spinal canal (the cerebrospinal fluid) for examination.
Lumbar Puncture also can be done to treat diseases. For example, as to how a way of administering antibiotics, cancer drugs, or anesthetic agents into the vertebral canal. RemovalSpinal fluid is to treat uncommon conditions (such as for example, normal-pressure hydrocephalus and benign intracranial hypertension).

How is the LP performed?

The procedure performed while the patient is typically lying down sideways for the procedure. Sometimes the procedure is performed while the patient is sitting up position. LPs in infants are often done upright.
After the administration of anesthesia, a needle is inserted in between the nearby bony building blocks (vertebrae) into the spinal canal. (Usually, the needle is placed between the 3rd and 4th lumbar vertebrae).

Spine puncture

1.Sample Report:
LUM SPINE PUNCTURE W/FLUORO
HISTORY:
Altered mental status, meningitis
PROCEDURE:
The patients placed on the fluoroscopy table in the prone position.
Using fluoroscopic guidance a 20-gauge spinal needle was introduced
at the level of L3-4 using an interlaminar approach. The patient has
then placed in the left side decubitus position. Opening pressure is
13. Cloudy spinal fluid was removed and placed in four separate tubes
for laboratory studies requested. The closing pressure is 11. The
needle was removed with no complications encountered.
IMPRESSION:
Successful lumbar puncture under fluoroscopy.

2.Sample Report:
PROCEDURE:
1. Lumbar puncture, treatment for drainage, code 62272/77003.
2. Procedure Time: 35 minutes ( without conscious sedation).
INDICATIONS: Patient with normal pressure hydrocephalus requires
therapeutic lumbar puncture.
OPERATOR: Krishna Iyer MD.
FINDINGS: Prior to performing the procedure, informed consent was
obtained. All risks, benefits, and alternatives were fully discussed.
The risks included but not limited to Pain, infection, neurologic
injury, allergic reaction, unexpected operation, disability, and
fatality. The patient placed in the prone position on the procedure table
and the midline lower lumbar spine region prepped and draped in the
usual sterile technique. 1% lidocaine was used for local subcutaneous
and deep anesthesia. Hemodynamic monitoring was administered by the
Radiologic nursing staff. A timeout was performed verifying the patient
name, medical record number, date of birth, and site of the procedure.
Using fluoroscopic guidance, with an image saved for future reference,
a 20 -gauge spinal needle was used to gain access to the L5-S1
para laminar spinal canal, atraumatic. Opening pressure was measured at
13.5 mmHg. 32 mL of clear CSF fluid was removed and submitted for
the specified examinations. The needle was
withdrawn with adequate hemostasis obtained. Vital signs remained
stable. Prior to transfer from the Radiology Department, the patient
was in a hemodynamically stable state.
IMPRESSION:
Opening pressure measured 13.5 mmHg.
Therapeutic lumbar puncture performed with the removal of 32 mL of
clear CSF, atraumatic. No immediate post-procedure complications

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