A Lumbar Puncture (Spinal Tap) for a Scoliotic?

[Eddie Sand]

I had a spinal fusion in the thoracic region (1 lumbar vertebra affected) waaay back in 1960 at age 10, and it has served me very well, but nothing comes with a lifetime guarantee, and at age 69, a couple of problems are turning up. Some (lumbosacral spondylosis and hemiatrophy) are undoubtedly scoliosis-related, but others might not be.

I began to experience balance and mobility issues about a year and a half ago, and hospitalization after an auto accident (treated by a different hospital) revealed a swollen ventricle on my brain stem; a neurological evaluation revealed neuropathy, particularly in my feet, (partially addressable by an ankle brace), but results of an EMG were inconclusive. A shunt to drain the excess fluid has also been suggested, and I can understand the rationale here (the ventricular issue was largely ignored after the accident until it resurfaced last week).

But I was more than a little suprised when a representative from the neurology department called me earlier this week, pushing (aggressively) to schedule a lumbar puncture. Supposedly, this would eliminate some other possibilities, such as Parkinson's disease, but several friends and relatives with some degree of peripheral medical exposure (pharmacy, physical therapy, veterinary) have advised me that they don't see too much of a connection and, while I've done some research and the pain might not be that intense, the possibility that my spine is far from normally-positioned probably increases the risk of an "unpleasant" (?) mistake in this case. I'm also told that each department has a tendency to over-recommend its own tests and procedures, whether absolutely essential or not.

So I'd appreciate hearing from anyone who has dealt with this procedure after a spinal fusion.

[titaniumed]

Eddie

I had a Tap in 2002. I had an Iohexol (Contrast agent) CT shot. This was done in my un-fused lumbar at that time....(Probably around L1)

This was done by an regular Orthopedic since we didn't have a scoliosis surgeon at that time in Reno.

I laid down on a flouroscope table, and they did a local. I could see my spine live moving on the monitor. It didn't take too long, and you have to stay still. They didn't pull a sample of CSF fluid to examine because I had asked. They look for things like MS, Cancer etc. My dad had ALS, that's why I asked. Not because of scoliosis.

Its nice to know who orders diagnostics and why? I know I would want to talk to the doctor about it.

Good luck

Ed

[LindaRacine]

Hi Eddie...

There are a bunch of us who have had lumbar punctures for one reason or another, including many who have their entire lumbar spines fused. It should not be a problem.

With that said, good for you questioning whether it's necessary. Perhaps you can ask that the doctor either spend a few minutes on the phone with you, or that you be allowed to make an office appointment, to discuss the reasons, risks, etc. of/for the procedure.

--Linda

[Eddie Sand]

Very happy to report that I underwent a lumbar puncture yesterday, and it turned out to be a piece of cake.

The worst part was a fairly long wait after getting "gowned up"; but after signing the release and downing the pills (1 mg of Lorazepam) I had about 10 minutes to sit on the table (a fluoroscope) while things were explained.

Then it was onto the table on my stomach where the "tactics" were drawn on my lower back in some sort of "surgical ink", and a shot of Lidocaine or Novocain was administered; I have a veterinarian brother who tells me that a lot of progress has been made regarding local anesthesia, and apparently, he's right. On to the main event, which involved the withdrawal of about 20cc's of cerebrospinal fluid; I didn't feel a thing.

One bit of friendly and (hopefully) positive advice to the medical profession; please remember that some of us are being exposed to "heavier" procedures after a long hiatus, and sometimes, we're carrying "psychological baggage" from those earlier times when pain management wasn't as much of a concern. It helps when the person explaining things is somewhat closer with regard to maturity.