Where is lumbar puncture performed in children?

Lumbar puncture does sound scary and is often painful for parents. Once the doctor says that the baby needs a lumbar puncture to test the cerebrospinal fluid, many parents will become very nervous. Lumbar puncture is a procedure in which a needle passes through the lumbar intervertebral space and enters the subarachnoid space in order to extract cerebrospinal fluid for testing. With the continuous advancement of medical science, lumbar puncture is also widely used in pediatrics and plays an important role in the treatment of children's diseases.

1. Lumbar puncture is a basic operation for a doctor. For anesthesiologists and neurologists, since almost every patient has to undergo this examination, they are familiar with the surgical operation and have a higher success rate. However, in pediatrics, especially infants and young children, they do not understand the significance of the examination and are very uncooperative. This is especially because the examination should be performed in a relatively clean or sterile treatment room. Parents are often unable to accompany their children, and the operation is sometimes difficult, and it is even impossible to correctly puncture the spinal cavity and successfully obtain cerebrospinal fluid. If this test is necessary for diagnosis, it should be done after the child has taken a sedative and is asleep.

2. Many parents have doubts about lumbar puncture, mainly because they have listened to some folk legends, such as lumbar puncture can make children stupid. Some people also mistakenly believe that lumbar puncture is to extract bone marrow. In fact, these legends are all wrong. Lumbar puncture is to obtain cerebrospinal fluid for examination; bone marrow puncture is to obtain bone marrow for examination. Doctors have to do this type of examination when suffering from malignant tumors such as leukemia, or when high fever and other reasons have not been cured for a long time and it is necessary to rule out malignant tumors.

3. In fact, lumbar puncture itself is just like puncturing a blood vessel to draw blood. It is a detection method to take out the fluid from a certain part of the body and check whether there are abnormal changes in the organs and tissues through which it flows. If the cerebrospinal fluid examination is normal and neurological diseases are ruled out, there will be no sequelae and the child will not become stupid. If cerebrospinal fluid examination proves that there is a disease in the nervous system, there will often be different sequelae depending on the nature of the lesion, the early or late onset of fever, or whether the treatment is thorough or not, such as hydrocephalus, mental retardation caused by brain cell necrosis, limb paralysis, etc. These are not caused by lumbar puncture, but by diseases of the nervous system. In our clinical work, we often encounter parents with low educational level, who do not understand the necessity of some examination methods, are stubborn and resolutely refuse to do lumbar puncture. Because the parents firmly disagree, the doctor cannot make a correct diagnosis of the disease, and the treatment is very blind, which affects the treatment. It is not until the child develops convulsions or coma that a lumbar puncture is done, but it is too late. Often after rescue, the sick child still has serious sequelae, and the parents regret it.

Of course, lumbar puncture is a invasive examination that will cause some pain to the child, and it is only part of a variety of examinations. Before performing a lumbar puncture, the doctor should try to understand the child's medical history, examine the child's various symptoms, repeatedly explain to the parents the purpose and significance of the examination, and obtain the parents' close cooperation.