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Analysis of the factors influencing headache and backache following lumbar puncture

Korean Journal of Pediatrics 2008;51(8):856-860.
Published online August 15, 2008.
Analysis of the factors influencing headache and backache following lumbar puncture
Sang Taek Lee, Sochung Chung, Yong Mean Park, Sun Hwan Bae, Jeong Jin Yu, Ran Lee
Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
요추 천자 후 발생하는 두통 및 요통에 영향을 주는 요인의 분석
이상택, 정소정, 박용민, 배선환, 유정진, 이 란
건국대학교 의학전문대학원 소아과학교실
Correspondence: 
Ran Lee, Email: leeran67@kuh.ac.kr
Abstract
Purpose
: This study aimed to examine the factors influencing the appearance of headache and backache following diagnostic lumbar puncture in children, focusing on the need for strict bed rest after lumbar puncture.
Methods
: We studied 70 two-fifteen-year-old pediatric patients who underwent diagnostic lumbar puncture from July 2005 to July 2007 at Konkuk University Hospital. We divided them into two groups. Patients in the first group (n=24) were allowed free mobility and patients in the second group (n=46) were to have strict bed rest for four hours after puncture. Data were analyzed by age, sex, number of puncture attempts, cell counts and pressure in the cerebrospinal fluid (CSF), duration of bed rest, and occurrence of headache and backache.
Results
: The rate of complications was not significantly related to sex, age, presence of enterovirus, CSF pressure, or postural headache. The occurrence of headache was significantly correlated with white blood cell (WBC) count in CSF (P= 0.043). Symptom frequency did not differ significantly between the groups. Backache was significantly related to the frequency of puncture attempts (P=0.046).
Conclusion
: Strict bed rest following diagnostic lumbar puncture in children does not influence headaches and backaches. These are respectively related to the WBC count on the CSF profile and the frequency of attempts. Therefore, after lumbar puncture, absolute bed rest is not necessary and patients are more comfortable with free mobility.
Key Words: Bed rest, Lumbar puncture, Postspinal tap headache


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