Lumbar drain
Last edit by Alaric Steinmetz on
Synonyms: LD, LLD
A lumbar drain system serves for the external diversion of cerebrospinal fluid and can also be used for the intrathecal application of medications.
Functionality
A lumbar drain system operates on a similar principle as an external ventricular drainage, that is, the diversion of excess cerebrospinal fluid. During a lumbar drain procedure, the intrathecal space is punctured via a lumbar puncture, and a thin, soft plastic catheter is placed within the dural sac to allow cerebrospinal fluid to be drained externally. Placement can be performed under local anesthesia, and an inserted catheter can be left in place for several days, depending on the indication.
Complications
In a retrospective study of 312 patients, the risk of bacterial meningitis with a lumbar drain system was approximately 4.2%[^1].
Transient headaches are observed in up to 60% of patients with lumbar drain systems[^2].
Transient radicular pain can be observed in approximately 3% of patients with a lumbar drain system[^2].
Contraindications
Both superficial and deep skin and subcutaneous tissue infections, as well as muscle infections at the puncture site, are contraindications for a lumbar drain system.
Spontaneous intracranial hypotension.
Disturbances in cerebrospinal fluid circulation, such as the presence of an aqueduct stenosis.
Increased intracranial pressure with the risk of herniation.
The risk of spinal hematoma with resulting paraparesis is about 0.3%[^3].
The risk of spinal hematoma without neurological deficits is about 1.3%[^3].
Illustration
