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When Your Child Needs a Spinal Tap

A spinal tap (also called a lumbar puncture) is a test that checks the health of the cerebrospinal fluid (CSF). This fluid surrounds the brain and spinal cord. During the test, a small sample of CSF is removed from the spinal canal to be tested in a lab. The test is safe and does not damage the spinal cord or nerves. Within a few hours your child’s body will make new fluid to replace what is removed. From start to finish, the test usually takes about 10 to 15 minutes. Side view of cross section of lower spine showing spinal cord in vertebrae. Nerves come off end of spinal cord and continue down back inside spine. Needle goes through skin and into space between nerves.Some results will be available within hours, and some results will take a few days to finalize. This procedure is usually done to evaluate for infection, although there are other reasons to perform a spinal tap. These include evaluation for bleeding in the brain, or look for the presence of other cells that may indicate the presence of central nervous system disease, such as multiple sclerosis or Guillain-Barré syndrome. Spinal taps are also performed in order to deliver medicines, such as chemotherapy, directly to the brain and spinal cord.  

Before the test

Follow all instructions given by your child’s healthcare provider to prepare your child for the test.

  • Your child needs to lie still during the test. If this will be difficult for your child, he or she may be given medicine (a sedative) ahead of time to help stay calm during the test. Anesthesia is also an option. This is medicine that causes your child to fall asleep and not feel pain or discomfort during the test.

  • If anesthesia will be used during the test, you’ll be given specific food, drink, and instructions for medicine to prepare your child. For instance, he or she may be told to not eat or drink for a certain number of hours before the test.

Let the healthcare provider know

For your child’s safety and best results, tell the healthcare provider if your child:

  • Takes any medicines, over the counter or medicines that may make your child more likely to bleed, like aspirin or ibuprofen. 

  • Is allergic to any medicines or iodine.

  • Has any health problems, specifically conditions that may increase risk for bleeding or elevated intracranial pressure. 

During the test

A spinal tap is performed by a trained healthcare provider. Ask your child’s healthcare provider in advance if you can stay with your child in the hospital room. Your child may bring along a favorite toy, such as a stuffed animal, for comfort.

  • Your child changes into a hospital gown and lies on a hospital bed.

  • If needed, anesthesia is given to your child. A trained nurse (anesthetist) or specialized healthcare provider (anesthesiologist) helps with this process. Special equipment is then used to monitor your child’s breathing, heart rate, and blood pressure.

  • If your child is awake during the test, he or she is asked to curl into a tight ball and then remain still.

  • Your child’s lower back is cleansed so that the skin area is sterile.  

  • Medicine is used to numb the area.

  • A hollow needle is then inserted through the back into the small space that holds the fluid in the spinal canal. Sometimes the needle is inserted more than once to find the best place to draw the fluid. Once the needle is in place, the fluid sample is slowly collected. The pressure of the fluid may also be measured.

  • After the fluid is collected, the needle is removed. The area is then cleaned and bandaged.         

After the test

  • Your child may be asked to lie still or rest for a few hours after the test. Be sure to follow any activity restrictions as advised by your child’s healthcare provider.

  • Some soreness in the low back is normal. A pain reliever, such as acetaminophen, may be recommended to help manage any discomfort.

  • Schedule a follow-up appointment with your child’s healthcare provider to review the results of the test.

Call your healthcare provider

Contact your healthcare provider if your child has any of the following: 

  •  Fever:

    • Temperature of 100.4°F (38.0°C) or higher

    • Your child has had a seizure caused by the fever

  • A headache that is severe or lasts longer than 2 days.

  • Muscle aches or lower back pain that is severe or lasts longer than 2 days.

  • Tingling or weakness in the legs.

  • Any change in behavior or level of activity

  • Your child is confused or hard to wake up 

  • Persistent bleeding or leakage of clear fluid from the site of the needle

  • Your child begins to act sicker or get worse  

 

Helping your child prepare

Many hospitals have people trained in helping children cope with their medical care or hospital experience. These people are often called child life specialists. Check with your child’s healthcare provider if child life programs or other similar services are available for your child. There are also things you can do to help your child prepare for a test or procedure. How best to do this depends on your child’s needs. Start with the tips below:

  • Use brief and simple terms to describe the test to your child and why it’s being done. Younger children tend to have a short attention span, so do this shortly before the test. Older children can be given more time to understand the test in advance.

  • Tell your child what to expect in the hospital during the test. For instance, you could mention who will be performing the test and what the hospital room will look like.

  • Make sure your child understands which body parts will be involved in the test.

  • As best you can, describe how the test will feel. For instance, if your child is awake during the test, he or she may feel some discomfort or pressure when the needle is inserted. Reassure your child that this discomfort won’t last long.

  • Allow your child to ask questions and answer these questions truthfully. Your child may feel nervous or afraid. He or she may even cry. Let your child know that you’ll be nearby during the test.

  • Use play when telling your child about the test, if appropriate. With younger children, this can involve role-playing with a child’s favorite toy or object. With older children, it may help to read books or show pictures of what happens during the test.

 

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