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Chapter 8: Lumbar Cerebrospinal Fluid Taps 87
Figure 8.2 Correct positioning of the patient in right lateral recumbency for a lumbar tap.
A B
C
Figure 8.3 Lumbar puncture at L5–L6. (A) Operator bending over the patient facing abdomen, identifying L6 spinous process with left hand, and inserting
spinal needle in its caudal aspect. (B) Once spinal needle is suspected to be in contact with the floor of the vertebral canal, remove stylet and check for CSF
flow. (C) If CSF is not present, readjust needle rotating and withdrawing it until CSF flows.
recommend performing the lumbar puncture in lateral recum- recumbency with the spine flexed produced a significantly larger
bency in a kyphotic position with the pelvic limbs advanced and L5–L6 interarcuate space aperture compared with lateral recumbency
flexed in an attempt to maximize the aperture of the interarcuate with the spine flexed, while both positions were superior to the
space. One study demonstrated that positioning a dog in sternal lateral neutral [12].
