Lumbar Puncture To Test For Childhood Cancer

Key points about lumbar punctures to test for childhood cancer

• a lumbar puncture is a procedure to see if there are cancer cells in the fluid that cushions the brain and spinal cord
• it is sometimes called a spinal tap
• most lumbar punctures happen while your child is asleep 
• if your child has a temperature of 38 degrees Celsius or higher after the procedure, phone the hospital straight away 

What is a lumbar puncture test for childhood cancer?

A lumbar puncture (also called a spinal tap) is a procedure to see if there are cancer cells in the fluid that cushions the brain and spinal cord. This fluid is called cerebrospinal fluid or CSF. 

With some cancers, such as leukaemia or lymphoma, cancer cells can pass into the brain and the CSF. To find out whether this has happened, a doctor or nurse will do a lumbar puncture. This involves removing a few drops of CSF fluid by putting a thin needle between 2 bones in the spine. 

What should I expect when my child has a lumbar puncture for childhood cancer?

During the procedure, your child will lie on their side with their chin tucked to their chest and knees pulled up. In some cases, tamariki (children) can sit up and curl their back by tucking their chin to their chest.

When the back is in a curved position, a doctor or nurse will put a needle between the bones of the spine (vertebrae). This is done between the bones at the lower part of the spine.

The doctor or nurse will draw out a small amount of spinal fluid into a tube and send it to the laboratory for testing. For some types of cancer, chemotherapy goes through the same needle after removal of the spinal fluid.

Most lumbar punctures happen under general anaesthetic, so your child will be asleep and will not feel anything or be aware of the procedure.

What happens after my child has their lumbar puncture?

The anaesthetist or another doctor will arrange medicine for any discomfort afterwards. Some older tamariki may choose to stay awake during a lumbar puncture. If your child wants to stay awake, they can have a local anaesthetic to help minimise discomfort.

Occasionally tamariki get a headache after a lumbar puncture, but it is not common. If this happens, the anaesthetist or another doctor will arrange medicine to relieve it. There is less chance of a headache happening if your child can lie down for 2 hours after the procedure. Sometimes, there can be a small amount of bleeding from where the needle was, but again, this is not common. 

The nurse will change the dressing and show you how to press on the area to stop the bleeding. Infections can sometimes start in the needle prick area. Your nurse will talk to you about how to avoid this happening.

Before going home, the nurse will give instructions about removing the dressing.

How can I care for my child at home after their lumbar puncture?

If your child has a temperature 38 degrees Celsius or higher, phone the hospital straightaway.

Take the dressing off 24 hours after the procedure. Follow the directions your nurse gave you in hospital.

Phone the hospital straight away and tell the doctor or nurse on the ward if you notice any of these in the needle prick area:

• redness
• heat (feels warmer than skin in other parts of the body)
• fluid oozing out

Take your child's temperature if you are in any way concerned. If it is 38 degrees Celsius or higher, phone the hospital straightaway and tell the doctor or nurse on the ward. If your child needs pain relief, follow the instructions your nurse gave you in hospital.

Read more about childhood cancer tests

Read more about childhood cancer