• Needle remains fixed in horizontal plane to back.
• Advance needle slowly until light resistance (a pop) is felt.
• Remove stylet and check for CSF flow.
• If no CSF flows, continue to advance the needle slowly.
• If CSF flows, connect flexible tubing to hub of lumbar puncture
• Allow CSF to flow through tubing into manometer.
• Hold base of manometer and stopcock at level of heart.
• Straighten the patient’s back and legs.
• When CSF stops advancing along manometer, measure opening pressure
• Collect CSF for studies.
• Measure closing pressure, if ...