Accurate prediction of the needle depth required for successful lumbar puncture.
BACKGROUND
The aim of this study is to formulate an accurate estimate of the spinal needle depth for a successful lumbar puncture in pediatric patients.


METHODS
This is a prospective study of pediatric oncology patients who had lumbar punctures in the course of their treatment. The distance from skin entry point to the tip of the spinal needle was measured after lumbar punctures were performed. The relationship between the depth of needle insertion with weight, height, body surface area, body mass index, intervertebral space used, ethnicity, and sex of patient were studied. Predictive statistical models were used for the formulation of the ideal lumbar puncture needle depth.


RESULTS
Two hundred seventy-nine patients who had nontraumatic lumbar punctures were studied. The patient characteristics were as follows: age, 0.5 to 15 years; weight, 7 to 63 kg; and height, 70 to 162 cm. Analysis using multiple regression tests with stepwise approach showed a strong relationship between the lumbar puncture needle depth and weight/height ratio. By using a predictive regression model, ideal depth of needle insertion (cm) = 10 [weight(kg)/height(cm)] + 1, with a regression coefficient r = 0.77.


CONCLUSIONS
This formula is accurate and practical with less complex calculations. However, further validation in a prospective study will be needed.
Chong
Sze Yee
SY
Department of Pediatrics, University of Malaya, Kuala Lumpur 50603, Malaysia.
Chong
Lee Ai
LA
Ariffin
Hany
H
D000293:Adolescent; D000367:Age Factors; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009339:Needles; D011446:Prospective Studies; D012016:Reference Values; D012044:Regression Analysis; D012737:Sex Factors; D013129:Spinal Puncture / Q000379:methods*