Lumbar Puncture

Abstract

The actual technique of lumbar puncture has not changed markedly since Quincke’s description of the procedure in 1891. Prior to Quincke’s lumbar puncture, Corning had performed the first dural puncture, injecting cocaine into the subarachnoid space at T11/12 — a dangerously high level — and Wynter had used a drainage procedure making an incision in the skin of a patient with tuberculous meningitis in the lumbar region to drain off CSF. Morton also used the method described by Wynter to treat tuberculous meningitis in 1891. While these early attempts at lumbar puncture were an improvement over trephining the skull, previously the only means of obtaining CSF, the method of Quincke using direct percutaneous puncture in the lumbar region was a vast improvement over his predecessors, both in terms of its simplicity and of its safety (Levinson, 1923). There have been few modifications of his procedure over the ensuing 100 years.