Nerve Damage During Spinal Taps Research Paper

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Nerves Damaged Spinal Tap

Nerves Damaged During Spinal Tap: Can a spinal tap cause a person pain, numbness and weakness in the right lower leg for life?

The complications resulting from lumbar puncture (spinal tap) have been well documented in the neurosurgical literature. These complications include mild backache, persistent headache, meningitis, and herniated disc, as well as inoculation of epidermal tissue, and the associated growth of epidermoid tumors (Siddiqi and Buchheit, 1982).

There have also been documented cases of nerve root injury associated with spinal tap. Siddiqi and Buchheit have reported a case of an impacted or herniated nerve root associated with lumbar puncture. The patient presented with pain in the lower left leg into the ankle. Their finding of an impacted herniated nerve root, presumably causing postmyelogram sciatica and worsening of the preexisting low-back pain, appears unique. The mechanism of such an injury is thought to be herniation of the nerve root into the spinal needle while the contrast medium or cerebrospinal fluid is being withdrawn after the spinal tap. This suggests that the stylet should be placed before the needle is withdrawn. This phenomenon occurs as the etiology of sciatica and persistent headaches following myelography. In addition to the nerve root strangulation, this event may prevent the normal closure of the arachnoid and dura at the puncture site and facilitate the prolongation of postspinal tap headaches.

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Hasegawa and Yamamoto (1999) present a case of herniated nerve root associated with lumbar puncture. A 66-year-old woman experienced progressive right-sided sciatic pain on gait without any causative episode. She had not had low back pain before this episode. She had hypertension and asymptomatic multiple cerebral infarction, which had been treated by hypotensor and anticoagulant.

On initial examination, she could not walk more than 100 m because of her right sciatic pain, which improved at rest. She showed no limitation on bilateral straight leg raising test. Neither sensory nor motor deficit of her lower extremities was apparent. Vesicorectal functions and reflexes were normal. Plain lumbosacral radiography showed mild lumbar spondylosis. Magnetic resonance imaging (MRI) of the lumbar region disclosed compression of the thecal sac at L4 -- L5 caused by a narrowed spinal canal. Lumbar puncture for myelography was performed without confirmation of the spinal level by an image intensifier. It was difficult to insert a needle (Termo spinal needle, 0.8 mm in diameter and 70 mm in length) into the….....

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