Does obesity preclude lumbar puncture with a standard spinal needle? The use of computed tomography to measure the skin to lumbar subarachnoid space distance in the general hospital population.

Hdl Handle:
http://hdl.handle.net/10147/296777
Title:
Does obesity preclude lumbar puncture with a standard spinal needle? The use of computed tomography to measure the skin to lumbar subarachnoid space distance in the general hospital population.
Authors:
Halpenny, Darragh; O'Sullivan, Katie E; Burke, John P; Torreggiani, William C
Affiliation:
Department of Radiology, Adelaide and Meath Hospitals incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.
Citation:
Does obesity preclude lumbar puncture with a standard spinal needle? The use of computed tomography to measure the skin to lumbar subarachnoid space distance in the general hospital population. 2013: Eur Radiol
Journal:
European radiology
Issue Date:
5-Jun-2013
URI:
http://hdl.handle.net/10147/296777
DOI:
10.1007/s00330-013-2909-8
PubMed ID:
23736376
Abstract:
OBJECTIVES: Failed lumbar puncture (LP) is a common indication for referral for radiologically guided LP. This study aims to evaluate what percentage of the hospital population would fail an LP using a standard 9-cm needle because of obesity and a skin to subarachnoid space distance greater than 9 cm. METHODS: Images of 402 consecutive patients undergoing computed tomography of the abdomen and pelvis were reviewed. Skin to subarachnoid space distance was calculated using sagittal images. A survey was conducted among junior hospital doctors to assess their experience of performing lumbar puncture in obese patients. RESULTS: Four hundred patients were included. Fifty-five patients (13.8 %) had a skin to subarachnoid space distance greater than 9 cm. Intra-abdominal fat, subcutaneous fat and abdominal girth correlated with distance between the skin and subarachnoid space. Among junior doctors, 68.3 % (n = 41) reported LP failure on an obese patient; 78.4 % (n = 47) were unaware of the existence of a longer needle and 13.3 % (n = 8) had experience using a longer needle. CONCLUSIONS: A significant proportion of the hospital population will fail LP with a standard length spinal needle. Selecting a longer needle may be sufficient to successfully complete LP in obese patients. KEY POINTS : • Lumbar puncture failure commonly leads to referral for an image-guided procedure • Standard lumbar puncture may fail in 13.8 % of patients due to obesity • 78.4 % of trainee doctors are unaware of the existence of longer spinal-needles • Using longer spinal needles may allow successful LP in obese patients.
Item Type:
Article
Language:
en
ISSN:
1432-1084

Full metadata record

DC FieldValue Language
dc.contributor.authorHalpenny, Darraghen_GB
dc.contributor.authorO'Sullivan, Katie Een_GB
dc.contributor.authorBurke, John Pen_GB
dc.contributor.authorTorreggiani, William Cen_GB
dc.date.accessioned2013-07-22T11:21:51Z-
dc.date.available2013-07-22T11:21:51Z-
dc.date.issued2013-06-05-
dc.identifier.citationDoes obesity preclude lumbar puncture with a standard spinal needle? The use of computed tomography to measure the skin to lumbar subarachnoid space distance in the general hospital population. 2013: Eur Radiolen_GB
dc.identifier.issn1432-1084-
dc.identifier.pmid23736376-
dc.identifier.doi10.1007/s00330-013-2909-8-
dc.identifier.urihttp://hdl.handle.net/10147/296777-
dc.description.abstractOBJECTIVES: Failed lumbar puncture (LP) is a common indication for referral for radiologically guided LP. This study aims to evaluate what percentage of the hospital population would fail an LP using a standard 9-cm needle because of obesity and a skin to subarachnoid space distance greater than 9 cm. METHODS: Images of 402 consecutive patients undergoing computed tomography of the abdomen and pelvis were reviewed. Skin to subarachnoid space distance was calculated using sagittal images. A survey was conducted among junior hospital doctors to assess their experience of performing lumbar puncture in obese patients. RESULTS: Four hundred patients were included. Fifty-five patients (13.8 %) had a skin to subarachnoid space distance greater than 9 cm. Intra-abdominal fat, subcutaneous fat and abdominal girth correlated with distance between the skin and subarachnoid space. Among junior doctors, 68.3 % (n = 41) reported LP failure on an obese patient; 78.4 % (n = 47) were unaware of the existence of a longer needle and 13.3 % (n = 8) had experience using a longer needle. CONCLUSIONS: A significant proportion of the hospital population will fail LP with a standard length spinal needle. Selecting a longer needle may be sufficient to successfully complete LP in obese patients. KEY POINTS : • Lumbar puncture failure commonly leads to referral for an image-guided procedure • Standard lumbar puncture may fail in 13.8 % of patients due to obesity • 78.4 % of trainee doctors are unaware of the existence of longer spinal-needles • Using longer spinal needles may allow successful LP in obese patients.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to European radiologyen_GB
dc.titleDoes obesity preclude lumbar puncture with a standard spinal needle? The use of computed tomography to measure the skin to lumbar subarachnoid space distance in the general hospital population.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Radiology, Adelaide and Meath Hospitals incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.en_GB
dc.identifier.journalEuropean radiologyen_GB
dc.description.fundingNo fundingen
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen

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