Technique for lumbar puncture through a tattoo

Passing a spinal needle through a tattoo is not known to result in adverse effects. However, skin cells can be carried into the spinal canal during lumbar puncture, rarely resulting in an intraspinal epidermoid cyst, and therefore, it is possible to introduce tattoo pigment into the spinal canal. The obstetrics anesthesia literature discusses targeting of a spared patch of skin within the tattoo or creation of a small stab wound through which the needle is then introduced.¹ A new alternative is to pass the spinal needle through a short, larger needle (figure).

Figure. Lumbar puncture.

A 1-inch 18-gauge needle is introduced through the tattoo using the planned angle for the spinal needle. A 22-gauge spinal needle is introduced through the 18-gauge needle. Adjustment of the needle angle remains straightforward. To ensure privacy, the details of this tattoo were altered with Photoshop.

Appendix. Author

Study funding

No targeted funding reported.

Disclosure

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