OBJECTIVE Penetration of intervertebral disc joint during lumbar puncture might be unnoticed during procedure. However, accelerated degeneration of the disc joint is a long-term consequence of inadvertent penetration. In this paper, we aimed to demonstrate and evaluate the risk of disc puncture during standard lumbar puncture. PATIENTS AND METHODS 50 human cadavers were used in this study. Disc puncture risk was assessed by using worst case scenario model. Lumbar puncture was performed in a standard fashion using midline route at L3-4, L4-5 and L5-S1 levels. The needle was advanced until it hit resistance from the bone. Lateral X-ray was used to visualize the needle position. Needle ended up in two possible locations - posterior vertebral body wall and intervertebral disc space. RESULTS The probability of puncturing the joint was 20 % for L3-4, 38 % for L4-5, 16 % for L5-S1. Total probability of disc penetration was 25 %. Statistical analysis revealed significantly increased risk for performing LP at L4-5 level in comparison with L5-S1 (p = 0.023). CONCLUSION Lumbar puncture carries significant risk of intervertebral disc penetration. This complication is not realized during the procedure and lead to accelerated joint degeneration.

中文翻译：

---

腰椎穿刺时椎间盘关节穿刺风险

目的 腰椎穿刺过程中椎间盘关节的穿透可能在手术过程中被忽视。然而，椎间盘关节的加速退化是无意中插入的长期后果。在本文中，我们旨在证明和评估标准腰椎穿刺过程中椎间盘穿刺的风险。患者和方法 本研究使用了 50 具人类尸体。使用最坏情况情景模型评估椎间盘穿刺风险。在 L3-4、L4-5 和 L5-S1 水平使用中线以标准方式进行腰椎穿刺。针头被推进，直到它碰到骨头的阻力。横向 X 射线用于可视化针位置。针最终在两个可能的位置 - 后椎体壁和椎间盘空间。结果 L3-4 的关节穿刺概率为 20%，L4-5 为 38%，L5-S1 为 16%。圆盘穿透的总概率为 25%。统计分析显示，与 L5-S1 相比，在 L4-5 水平执行 LP 的风险显着增加（p = 0.023）。结论腰椎穿刺具有显着的椎间盘穿透风险。这种并发症在手术过程中没有实现，会导致关节退化加速。