Karambelkar Ajit, De Jesus Orlando
Thomas Jefferson University and Hospital
University of Puerto Rico, Medical Sciences Campus, Neurosurgery Section
Heinrich Irenaeus Quincke and Walter Essex Wynter independently developed techniques to perform lumbar punctures in 1888, and 1889 respectively. Lumbar puncture (LP) is one of the most common procedures, with over 90,000 procedures performed in 2018 on the Medicare population. Currently, radiologists are becoming the largest provider for LP. There is an increasing trend of performing LP under image guidance in hospital settings. Fluoroscopy-guided lumbar puncture (FGLP) is the most common imaging method. Physicians have used computed tomography (CT) guidance lumbar puncture in certain difficult situations. FGLP is necessary when a patient has spinal hardware, scoliosis, and severe degenerative changes. Prior failed attempts and inability to find the bony landmarks such as in obese patients also require image guidance for the procedure. FGLP is associated with a 3.5% frequency of a traumatic tap, which is much lower than the 10.1% associated with the blind bedside technique.
海因里希·伊雷内乌斯·昆克和沃尔特·埃塞克斯·温特分别于1888年和1889年独立研发出了进行腰椎穿刺的技术。腰椎穿刺（LP）是最常见的操作之一，2018年医疗保险人群中进行了超过90000例该操作。目前，放射科医生正成为腰椎穿刺的最大提供者。在医院环境中，在影像引导下进行腰椎穿刺的趋势日益增加。荧光透视引导下腰椎穿刺（FGLP）是最常见的成像方法。在某些困难情况下，医生会使用计算机断层扫描（CT）引导下的腰椎穿刺。当患者有脊柱内固定装置、脊柱侧弯和严重退行性改变时，FGLP是必要的。先前穿刺失败以及无法找到骨性标志（如肥胖患者）时，该操作也需要影像引导。FGLP导致创伤性穿刺的发生率为3.5%，远低于床边盲目操作的10.1%。
