What to do when the needle encounters the bone during spinal or lumbar puncture
Have you ever experienced or witnessed a “difficult” spinal puncture in a young, slim patient with landmarks visible from a mile? In these cases, no matter what you do, you always seem to hit the bone. In fact, I will dare to say that most struggles with spinal that I have witnessed were in skinny patients with easy landmarks. In this video, you will learn 4 specific tips and techniques that will make your next spinal anesthesia or lumbar puncture MUCH easier and more predictable. Here’s the KEY to success when the needle hits bone all the time. Ask yourself: Which bone is preventing me from placing the needle successfully? Or which osseous structure is on my way to the subarachnoid space? In this video we first review the anatomical structures the needle is passing through when performing a midline approach to spinal anesthesia or lumbar puncture: Skin, SQ tissue, Supraspinous ligament, Interspinous ligament, Ligamentum flavum, Dura, Subarachnoidal space. Dr Hadzic then moves on to describe WHAT you need to do AFTER encountering the bone on your way to the CSF in 4 typical scenarios.
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Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA’s Youtube channel is accurate.
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