Are there differences in the types of needles used for lumbar punctures?

Helpful question?


The lumbar puncture kits I have used usually have quincke spinal needles. I didn’t think much of it but I noticed that some anesthesia colleagues don’t use quincke needles when they do spinals, which are essentially the same procedure. Why is this? And why aren’t they used in lumbar puncture kits?

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Helpful answer?


Pencil point needles have been shown to reduce the rate of post dural puncture headaches by at least a few percentage points (when compared to cutting needles like quinckes). This article below [1] also suggests that the rate of epidural blood batch was less when using pencil point needles.

A study done at a danish neurology department addressed the specific issue of using non-cutting needles in LP kits. It showed similar results [2]. It even measured a lot of secondary markers like days away from work, hospitalizations, etc and in several metrics the results were better.

[1] Postdural puncture headache: a randomized comparison of five spinal needles in obstetric patients.
[2] Changing the needle for lumbar punctures: Results from a prospective study

Helpful answer?


Although I can’t support it from personal experience I’ve heard others say quincke needles provide better feedback. But along these lines this article suggests better results with a non-cutting needle: Changing the needle for lumbar punctures: Results from a prospective study

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