Contraindications and precautions for lumbar puncture

Lumbar puncture, a commonly used diagnostic procedure in neurology, must be performed strictly in accordance with specific contraindications and precautions. Major contraindications include: local infection, increased intracranial pressure, coagulation disorders, lumbar spine abnormalities, high cervical spinal cord compression, and bleeding tendencies.

Local infection may lead to spread of infection into the spinal canal; increased intracranial pressure can trigger brain herniation; and coagulation disorders may result in significant hemorrhage within the spinal canal. Regarding precautions, it is essential to confirm the absence of the aforementioned contraindications in the patient. During the procedure, the physician should use gentle techniques, avoid forceful manipulation, and closely monitor the patient's vital signs. After the puncture, the patient should lie flat without a pillow for 4–6 hours, avoid severe coughing, and promptly report any discomfort to the physician.