Lumbar puncture needle length determination



      Appropriate lumbar puncture (LP) needle length selection may be more difficult for less experienced practitioners or for patients who are of unusually large or small body habitus. The purpose of this study is to determine if there is a relationship between body height and weight, and the percutaneous depth to the spinal canal, which can more reliably assist in selecting an LP needle length.


      This is a retrospective cohort study of patients who received an abdominal computed tomographic scan (for any reason) from July 1999 to December 2000. Lumbar puncture depth was measured on the computed tomographic scan and was used to derive a formula.


      The final data pool consisted of 175 patients, aged 25 days to 80 years, with height of 48 to 181.5 cm, weight of 3.0 to 127.3 kg, and body mass index of 11.7 to 49.7 kg/m2. Using this data set, the formula for predicting the required LP depth is (weight in kilograms, height in centimeters):
      LP depth (cm) = 1 + 17 × weight height .

      Using linear regression comparing the skin to mid–spinal canal depth measurements with the calculated LP depths, R2 was 0.81 (P < .001). This formula selected a needle that was too short in 6% (less than that of 4 other previously published LP needle length selection methods) and a needle that was too long in 31%.


      Compared with other formulas, this formula might be a more reliable predictor for estimating the required LP needle length, but this must be validated by further studies. It should be noted that none of the formulas were perfect.
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bonadio W.A.
        • Smith D.S.
        • Metrou M.
        • Dewitz B.
        Estimating lumbar-puncture depth in children.
        N Engl J Med. 1988; 319: 952-953
        • Craig F.
        • Stroobant J.
        • Winrow A.
        • Davies H.
        Depth of insertion of a lumbar puncture needle.
        Arch Dis Child. 1997; 77: 450
        • Hasan M.A.
        Depth of epidural space in children.
        Anaesthesia. 1994; 49: 1085-1087
        • Henretig F.M.
        • King C.
        Textbook of pediatric emergency procedures. Lippincott Williams & Wilkins, Philadelphia1997: 541-551