A Retrospective Study of Ultrasound Guidance for Diagnostic Lumbar Punctures

Lumbar puncture (LP) is a common procedure in various medical specialties to aid in diagnosis, despite the relatively high occurrence of complications, of which postLP headache is most notable. Ultrasonography, as an adjuvant to osseous palpation, may increase the success rate and decrease the rate of post-LP headache. Through a retrospective chart review of all patients who underwent an LP in the past year at the Wake Forest School of Medicine Diagnostic Neurology Laboratory, LP success rate and post-LP headache rate were compared between those who had ultrasound guidance prior to the procedure and those who did not. A total of 109 individuals were included in the review, with 95 having ultrasound guidance and 14 without. LP success rates were similar between the groups, but the ultrasound group had a lower rate of post-LP headache compared to the non-ultrasound group when assessed by patient phone calls (12.8% vs. 25.0%, p=0.289) and visits to the emergency department (3.9% vs. 8.3%, p=0.334) for headache, though these differences did not reach statistical significance. Further examination of the benefit of ultrasound guidance should be explored through a randomized clinical trial with cost efficacy included as an outcome measure.