Variability of Infant LP Insertion Site Based On Procedural Experience

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT02949869

Enrollment

110

Registered

2016-10-31

Start date

2016-11-30

Completion date

2018-08-31

Last updated

2018-11-01

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Traumatic Lumbar Puncture

Brief summary

The reported rate of unsuccessful traditional LP in children (defined as the inability to obtain cerebrospinal fluid or obtaining a traumatic puncture) is as high as 50%. Many factors affect LP success including provider experience. CSF is obtained by puncturing the subarachnoid space (traditionally at the L3-L4 or L4-L5 interspinous process space), and many have hypothesized that the width of this space may predict success. Anecdotally, trainees and those with less experience, tend to perform the LP too low (caudally), where the subarachnoid space tapers, or too laterally (off the midline) resulting in higher failure rates. The investigators seek to determine if planned LP insertion sites vary between training and attendings, and if so, could the decreased success be explained by smaller subarachnoid spaces.

Interventions

OTHERSpinal Sonography

As described previously

Study design

Allocation

Intervention model

SINGLE_GROUP

Primary purpose

DIAGNOSTIC

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

No minimum to 12 Months

Healthy volunteers

Yes

Inclusion criteria

1. Less than or equal to 12 months of age 2. Availability of a study sonographer to perform bedside ultrasound

Exclusion criteria

1. Prior history of LP in preceding 72 hours 2. Known spinal cord abnormality (i.e., tethered cord, spina bifida) 3. Clinically unstable patients (acuity level 1)

Design outcomes

Primary

Measure	Time frame	Description
Proportion of Trainee & Attending LP Insertion Sites that are the same	18 months	Plan to visualize marked spaces with US to delineate if the trainee and attending marked the same or different interspace (we will quanity the proportion of same interspaces marked and for those that are different, we will quantify the proportion above or below the attending marking)

Secondary

Measure	Time frame	Description
Subarachnoid Space Width	18 months	Measure subarachnoid space width (mm)
Subarachnoid Space Area	18 months	Measure subarachnoid space area (mm2)

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026