CSF tapping, site and position

Method of lumbar puncture 1) Carried out between L3-4 or L4-5 interspace located by the level of the iliac crest 2) Insert the bevel of the needle parallel to the long axis of the spine 3) If manometric studies and myelography are not being performed, use a 20 or 22 guage needle. 4) Note the opening and closing pressure as well as the amount of fluid removed

CSF 1. Protein, sugar, other chemistry 2. Cytology 3. VDRL, cryptococcal antigen, serologic and genetic test for micro-organism 4. Immunoelectrophoresis, oligoclonal band 5. Bacteriologic cultures and viral isolation 6. Cell count, differential count