Should a lumbar puncture be done in a fused area of the back?

Difficult: The question is-can a lumbar puncture be done in an area of a fused back. It depends on what was done and where the instrumentation and fusion mass is.If the lamina are intact and the fusion mass is in part directly over this, it would be very difficult to get the needle through it. Metal cross bars make it difficult also.If there is a laminectomy defect, access might be easier.Fluorography helps.

More difficult: The fused area sometimes does not have as clear an anatomy ...... It will be harder to get the needle where it needs to go. If there is quite a lot of bone overlying the area, i will not be able to get him the pca.