What to do when the needle encounters the bone during spinal or lumbar puncture

Have you ever experienced or witnessed a “difficult” spinal puncture in a young, slim patient with landmarks visible from a mile? In these cases, no matter what you do, you always seem to hit the bone. In fact, I will dare to say that most struggles with spinal that I have witnessed were in skinny patients with easy landmarks. In this video, you will learn 4 specific tips and techniques that will make your next spinal anesthesia or lumbar puncture MUCH easier and more predictable. Here’s the KEY to success when the needle hits bone all the time. Ask yourself: Which bone is preventing me from placing the needle successfully? Or which osseous structure is on my way to the subarachnoid space? In this video we first review the anatomical structures the needle is passing through when performing a midline approach to spinal anesthesia or lumbar puncture: Skin, SQ tissue, Supraspinous ligament, Interspinous ligament, Ligamentum flavum, Dura, Subarachnoidal space. Dr Hadzic then moves on to describe WHAT you need to do AFTER encountering the bone on your way to the CSF in 4 typical scenarios.

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