The failed lumbar puncture

Lumbar puncture (LP) is one of the few procedures that neurologists routinely perform and one for which they usually take pride in their performance skills. Rare is the seasoned neurologist who needs fluoroscopy to perform an LP. However, for the neophyte, the successful performance of an LP can be difficult, especially in the uncooperative, immobilized, or large patient. A common excuse for an unsuccessful LP in a large patient is that the standard (3.5-in) needle is too short. Although a number of articles discuss the technique of performing …