진단적 요추천자후 발생한 두통과 요통에 대한 임상적 고찰

Abstract

Purpose: Diagnostic lumbar puncture is one of the most frequently performed diagnostic procedure in children. Headache and backache are common complications of it. There are a few reports about them and they are not comparable among them and author’s experiences. I studied the clinical features and factors for occurrence of them.

Methods: I collected and investigated the clinical informations of 187 patients aged 2 to 15 years old who received a diagnostic lumbar puncture from January 2003 to December 2006 at YongIn Severance Hospital, YongIn, Korea. Their clinical parameters such as age, sex, puncture frequency, cell count in cerebrospinal fluid, periods of their absolute bed rest, presence and treatment results of headache and backache after lumbar puncture were analyzed retrospectively.

Results: Headache was observed in 20 (10.7%) patients. There was a tendency that it was more common in 10 and over years old than in under 10 (16.3% vs 8.3%). Backache was observed in 68 (36.4%) patients. It was more frequent in 10 and over years old than under 10 (47.5% vs 31.8%. P=0.045). The other factors did not show any statistical significance for their occurrence. The duration of headache and backache was longer in 10 and over years old (3.0±2.4 days and 3.2±2.5 days) than under 10 (1.9±0.5 days and 2.0±1.8 days). The duration of backache in 10 and over years old treated with bed rest and medication only was 3.4±2.2 days and it with bed rest, medication, hot pack and massage on back area was 1.7 ±1.4 days.

Conclusion: The occurrence rate of headache and backache after diagnostic lumbar puncture drawed their clinical significance. More frequent and longer morbidity were observed in 10 and over years old than 10. More supportive care could shorten the time of backache. I propose more supportive care and education for them.