Is Ultrasound-assisted Lumbar Puncture Superior to a Landmark-based Approach?

Richmond, R. and Varsou, O. (2022) Is Ultrasound-assisted Lumbar Puncture Superior to a Landmark-based Approach? SINAPSE 14th Annual Scientific Meeting, Glasgow, UK, 13-14 June 2022.

Abstract

Introduction: A lumbar puncture (LP) is a common but difficult procedure to collect cerebrospinal fluid (CSF). A needle is inserted into a patient’s vertebral column between the lumbar level 3 to lumbar level 4 (L3–L4) intervertebral space. This procedure might require multiple attempts at needle insertion to locate the correct intervertebral space, which can be time consuming and painful. The L3–L4 space is usually identified through palpation. If the wrong intervertebral space is located, this will result in an unsuccessful procedure. The use of ultrasound (US) to help identify the correct intervertebral space has recently become a commonly employed technique. Literature states that LP performed with the aid of an US is advantageous in infants and children as it allows for easier identification of the intervertebral space. However, this has not been researched extensively in adults. Aims and Methods: This systematic review aimed to determine if US-assisted LP is superior to a landmark/palpation-based approach in adult populations by assessing the number of needle insertions, the time of procedure, pain experienced by the patient and the rate of complications. Findings: PubMed, Web of Science and Science Direct were searched to identify current literature published on this topic between 2016 and 2021. Overall, 6 papers were included in this review. Four papers stated that US-assisted LP was not statistically better than the traditional palpation method. In some of the studies, it was discussed that an US-assisted procedure required less needle insertions, was quicker to perform and patients experienced less pain with less unsuccessful attempts when compared to the traditional palpation method. However, these results were not statistically significant. Conclusion: Considering the scarcity of literature, further research is required to determine if US-assisted LP is superior to a landmark-based approach in adult populations.

• Item Type: Conference or Workshop Item
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Varsou, Dr Ourania
• Authors: Richmond, R., and Varsou, O.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing