Abstract Details

Title ‘UltraGUD LP’—A Randomized Controlled Trial: Traditional Landmark-based Lumbar Puncture Is as Effective as Ultrasound-guided Lumbar Puncture in Outpatient Neurology Settings

Topic General Neurology

Presentation(s) P7 - Poster Session 7 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-012

Objective The objective of this study was to compare the effectiveness of Ultrasound Guided Diagnostic Lumbar Puncture to Traditional Landmark based method and compare the success and complications rate.

Background Lumbar puncture is a common neurologic procedure done in inpatient and outpatient settings to obtain cerebrospinal fluid. Success or failure depends on various factors, including age, body mass index, prior back surgery, spine anatomy, expertise of the performer and technical aspects. Studies done in emergency departments, pediatrics and anesthesia settings have shown mixed results with overalls superiority of ultrasound guided technique. There is a paucity of studies done in neurology to look at the benefits of ultrasound guided LP over traditional LP in outpatient or inpatient settings. In “Ultra GUD LP - Ultrasound Guided Diagnostic Lumbar Puncture in Neurology” study, we compared the effectiveness of both techniques in an outpatient neurology setting.

Design/Methods The study was a prospective randomized control study done in clinic settings from 2017 to 2022 with approval by local IRB and registered on Clinical Trials.gov We enrolled subjects needing lumbar puncture from the outpatient neurology clinics at the author's institution. After written informed consent, subjects were randomized into a traditional-landmark based or ultrasound guided LP approach. The primary author performed all LPs using a standard spinal needle in a similar fashion.

Results Traditional landmark based LP proved to be as effective as Ultrasound-guided LP in obtaining CSF with a similar success and complication rate with significantly less time taken in the study population.

Conclusions Ultrasound guidance doesn’t significantly affect outcomes of lumbar puncture in the regular adult population. Performer expertise and study settings are also important factors in a successful lumbar puncture. Ultrasound use in specific populations with high BMI, prior back surgeries, deformities of the spine need to be studied further

Authors/Disclosures
Vijay Renga, MD PRESENTER	Dr. Renga has nothing to disclose.
Charlotte Jeffreys	Charlotte Jeffreys has nothing to disclose.
Todd Mackenzie (dartmouth college)	No disclosure on file
Afsha Tabasum	No disclosure on file

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