Background:
Post‑lumbar puncture headache (PLPH) is the commonest complication of lumbar puncture (LP). It worsens patient experience, prolongs length of stay and drives additional interventions. Meta-analytic data demonstrate that atraumatic (non-cutting) needles significantly reduce the incidence of post-LP headache and related interventions.(Nath et al., 2018) The primary aims of our audit were to assess the prevalence and severity of post-LP headache, documentation quality, and needle choice (traumatic versus atraumatic needles) across departments in a tertiary hospital in the East Midlands.
Methods:
We retrospectively reviewed the healthcare records of 62 patients who developed post-lumbar puncture headaches between January 2020 and February 2025. Data on demographics, procedural details (needle type, LP site) and outcomes were analysed. An anonymised electronic questionnaire assessed clinicians’ knowledge of PLPH and perceived barriers to using atraumatic needles.
Results:
Most PLPH episodes (64.5 %) followed LPs performed in acute medicine, where traumatic needles are still widely used. Documentation was poor: needle type was recorded in only 8% of cases (all cutting needles). Pain scores were missing in 61.3% but when documented, 83.3% were reported as severe (8–10/10). 80% of post LP headaches required readmission, with patients either being readmitted or if not, requiring a 4 times prolonged length of stay.
While 83 % of operators recognised that atraumatic needles reduce PLPH risk, only 28 % reported using them routinely; the remainder relied on whichever needle was available. Reported barriers were limited stock (50 %) and lack of hands‑on training (33 %) .
Conclusion:
PLPH imposes a measurable inpatient burden yet key procedural details, especially needle type, are seldom documented. High PLPH rates likely reflect routine use of cutting needles in acute medicine, where atraumatic alternatives are rarely stocked. Ensuring consistent ward‑level availability of atraumatic needles, mandating needle‑type recording and delivering practical training could close the knowledge‑practice gap and reduce PLPH related morbidity and related resource use.
