Use of atraumatic spinal needles among neurologists in the United States

Objective.-To evaluate atraumatic spinal needle use among US neurologists. Background.-Postdural puncture headache following lumbar puncture may be dramatically reduced through the use of atraumatic pencil-point spinal needles. It was hypothesized that atraumatic spinal needles are rarely used by members of specialties outside of anesthesiology. To determine the extent to which atraumatic spinal needles are currently being used for lumbar puncture in the United States, American neurologists (one group of physicians who regularly perform lumbar punctures) were surveyed. Methods.-A questionnaire was mailed to all 7798 members of the American Academy of Neurology listed in the membership directory. The questionnaire included items pertaining to age, practice setting, knowledge of pencil-point (atraumatic) spinal needles, and lumbar puncture practices. Results.-Only a fraction (2%) of the neurologists surveyed routinely use atraumatic spinal needles. Almost half of the responding neurologists reported having no knowledge of pencil-point spinal needles. Among those who did have knowledge of these new spinal needles, the most common reasons given for not using them were nonavailability and expense. Conclusions.-Atraumatic spinal needles for lumbar puncture have been shown to dramatically decrease the risk of postdural puncture headache. Although the use of these needles is standard practice among anesthesiologists, they have not been adopted by other medical specialties. This may lead to unnecessary morbidity among patients undergoing lumbar puncture.