Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
    • Without Borders
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
    • Article CME
    • Podcast CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
    • Without Borders
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
    • Article CME
    • Podcast CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Practice Current

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
Neurology Clinical Practice
Home
A peer-reviewed clinical neurology journal for the practicing neurologist
  • Subscribe
  • My alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Practice Current

Share

September 16, 2019Research

Ultrasound-guided lumbar puncture improves success rate and efficiency in overweight patients

Yi Li, Raphael A. Carandang, Swetha Ade, Julie Flahive, Kate Daniello
First published September 16, 2019, DOI: https://doi.org/10.1212/CPJ.0000000000000725
Yi Li
Department of Neurology (YL, RAC, SA, KD), University of Massachusetts Medical School; Quantitative Health Sciences (JF), University of Massachusetts Medical School, Worcester; and Department of Neurology and Neurological Sciences (YL), Stanford University Medical Center, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Raphael A. Carandang
Department of Neurology (YL, RAC, SA, KD), University of Massachusetts Medical School; Quantitative Health Sciences (JF), University of Massachusetts Medical School, Worcester; and Department of Neurology and Neurological Sciences (YL), Stanford University Medical Center, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Swetha Ade
Department of Neurology (YL, RAC, SA, KD), University of Massachusetts Medical School; Quantitative Health Sciences (JF), University of Massachusetts Medical School, Worcester; and Department of Neurology and Neurological Sciences (YL), Stanford University Medical Center, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Julie Flahive
Department of Neurology (YL, RAC, SA, KD), University of Massachusetts Medical School; Quantitative Health Sciences (JF), University of Massachusetts Medical School, Worcester; and Department of Neurology and Neurological Sciences (YL), Stanford University Medical Center, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kate Daniello
Department of Neurology (YL, RAC, SA, KD), University of Massachusetts Medical School; Quantitative Health Sciences (JF), University of Massachusetts Medical School, Worcester; and Department of Neurology and Neurological Sciences (YL), Stanford University Medical Center, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Ultrasound-guided lumbar puncture improves success rate and efficiency in overweight patients
Yi Li, Raphael A. Carandang, Swetha Ade, Julie Flahive, Kate Daniello
Neurol Clin Pract Sep 2019, 10.1212/CPJ.0000000000000725; DOI: 10.1212/CPJ.0000000000000725

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
39

Share

  • Article
  • Info & Disclosures
Loading

Abstract

Background Approximately 400,000 diagnostic lumbar punctures (LPs) are performed by neurologists yearly in the United States. There has been a transition from neurologists performing >40% of LPs 2 decades ago to now <15% of the time. High body mass index (BMI) is one of the key obstacles of LP for neurology residents, and the success rates drop to 58% when BMI is >35 kg/m2.

Methods A prospective intervention study was conducted from March 2017 to March 2018 at an academic medical center. Patients were divided into ultrasound-guided LP or conventional LP. The primary outcome was the success rate of LP. The secondary outcome was the parameters regarding LP performance, the patients' feedback after procedures, and the residents' feedback about the learning modules.

Results Eighty-two patients were enrolled with inclusion criteria of age >18 years, BMI ≥25 kg/m2, and able to give written informed consent. The ultrasound-guided LP group showed higher success rate (92.7% vs 68.3%, p < 0.05) and less duration of time (17.02 vs 37.63 minutes, p < 0.05) compared with the conventional LP group. It also showed advantages of decreased trials of needle insertions and redirections and reduced pain levels perceived by patients.

Conclusions This study suggests that using ultrasound to localize before LP could increase the LP success rate and improve other related LP outcomes in the overweight populations. Our study also provides evidence that brief, targeted teaching modules are feasible and effective for ultrasound-guided LP training.

Classification of evidence This study provides Class III evidence that for patients with BMI ≥25 kg/m2 undergoing LP, ultrasound guidance increases the LP success rate.

  • Received March 31, 2019.
  • Accepted August 2, 2019.
  • © 2019 American Academy of Neurology

AAN Members: Sign in with your AAN member credentials (e-mail or 6-digit Member ID number)

Non-AAN Member Subscribers: Sign in with subscriber credentials

Log in using your username and password

Forgot your user name or password?

Purchase access

AAN members must change their passwords on the AAN site

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

The Nerve!: Rapid online correspondence

No comments have been published for this article.
Comment

NOTE: All contributors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.cp.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within the last 8 weeks.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on The Nerve!

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate The Nerve! Submission Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
  • Info & Disclosures
Advertisement

Related Articles

  • No related articles found.

Topics Discussed

  • All Clinical Neurology
  • Models of care

Alert Me

  • Alert me when this article is cited
  • Alert me if a correction is posted
  • Alert me when eletters are published
Neurology: Clinical Practice: 9 (6)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology: Clinical Practice |  Print ISSN: 2163-0402
Online ISSN: 2163-0933

© 2019 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise