Usefulness and challenges of using an atraumatic needle for diagnostic lumbar puncture

Abstract

Objective : Post–lumbar puncture headache (PLPH) is a prominent complication of diagnostic lumbar puncture (dLP). Using a non–traumatic needle (Sprotte type) instead of a conventional puncture needle (Quincke type) is known to reduce the incidence of PLPH, but such needles are infrequently used. We aimed to investigate the usefulness of dLP using S needles and highlight potential challenges.

Methods : Eighty–seven consecutive dLP cases from 2016 were retrospectively reviewed. We compared patient backgrounds, frequency and duration of PLPHs, and treatment groups according to needle type.

Results : Twenty–one and thirty–one dLPs were performed using a non–traumatic needle group and a conventional puncture needle group, respectively. No differences were observed in terms of age, sex, body mass index, or underlying condition. PLPH incidence was significantly lower in the non–traumatic needle group than that in the conventional puncture needle group (0 vs. 7, respectively ; 22.6% ; P < 0.03). Six patients required intravenous fluid replacement for an average of 5.5 days. Two difficult puncture cases were identified in the non–traumatic needle group : older adult patients with considerable lumbar spine lesions and those with high skin resistance or stiffness that was impenetrable with the needle.

Conclusion : A non–traumatic needle is beneficial in reducing PLPH during a dLP especially in younger populations.