Safety of lumbar puncture in patients with hemophilia

Study objective: To determine the safety of lumbar puncture in patients with hemophilia who are pretreated with clotting factor. Design: Retrospective analysis of medical records between 1980 and 1990. Setting: Three hospitals, each serving as a regional hemophilia center. Participants: Thirty-three patients with hemophilia A or B who received one or more lumbar puncture. Intervention: All patients received replacement of deficient factor before the lumbar puncture. Serious post-lumbar puncture complications were defined as motor or sensory deficits, incontinence, or documented intraspinal hemorrhage. Results: Thirty-three patients with hemophilia A or B received a total of 52 lumbar punctures during the study period. Thirty of 33 patients (91%) had severe baseline factor deficiency, two (6%) had moderate deficiency, and one (3%) had mild deficiency. There were no serious complications reported as a result of the lumbar puncture. The 95% confidence interval for the risk of a serious complication was 0% to 5.8%. Conclusion: With adequate factor replacement, a lumbar puncture can be done safely in patients with hemophilia.