Neuroimaging

Myelography and Lumbar Punctures

Rates of Complications Following Lumbar Puncture

2019

The Center for Neuroimaging routinely performs lumbar punctures on inpatients and outpatients under fluoroscopic guidance for the referring services. Lumbar punctures may be requested for diagnostic purposes in difficult patients, for therapeutic cerebrospinal fluid (CSF) drainage, or for the injection of chemotherapeutic, gene therapy, or radiopharmaceutical agents to ensure safe subarachnoid injections. Intrathecal injections for subsequent CTs of the cervical, thoracic, and/or lumbar spine on inpatients and outpatients are also performed for the referring services. These procedures require lumbar or cervical punctures under fluoroscopic guidance. Complications related to intrathecal contrast have not been an issue so the only complications relate to the needle punctures themselves causing CSF leaks and symptoms of CSF hypotension. The complication rate has been measured by reviewing secondary diagnoses and supplementary manual review of the electronic medical record to identify complications that were a direct result of these procedures and required blood patches to resolve symptoms of CSF hypotension. Quarterly review during 2019 demonstrates that the complication rate was approximately 1.1% in more than 1300 patients. Since 2015, the rate has been just under 1.4% for nearly 5100 patients.

Complication Rates of Severe Headache Following Lumbar Puncture or Myelography

2015 – 2019

Annual review during the past 5 years demonstrates that the complication rate following lumbar puncture has been relatively constant at approximately 1.4% in just more than 5100 patients.

Rates of Complications Following Lumbar Puncture

2015 – 2019

Quarterly review during the past 5 years demonstrates that the complication rate was approximately 1.4% in nearly 5000 patients.

Rates of Complications Following Myelography

2015 – 2019

The Center for Neuroimaging routinely performs intrathecal injections of contrast under fluoroscopic guidance for subsequent CTs of the cervical, thoracic, and/or lumbar spine on inpatients and outpatients for the referring services. Complications related to intrathecal contrast have not been an issue so the only complications relate to the needle punctures themselves. The complication rate has been measured by reviewing secondary diagnoses and supplementary manual review of the electronic medical record to identify complications that were a direct result of these procedures and required blood patches to resolve symptoms of CSF hypotension. Quarterly review during the past 5 years demonstrates that the overall complication rate was approximately 1.5% in 594 patients.