{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:45:59Z","timestamp":1790937959817,"version":"4.1.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Lumbar puncture (LP) is a fundamental procedure in neurology, yet its success is influenced by patient anatomy and provider expertise. Ultrasound guidance has been shown to improve outcomes in emergency and anesthesia settings, but its effectiveness in outpatient neurology remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study (UltraGUD LP) aimed to compare the effectiveness of ultrasound-guided LP (US-LP) versus landmark-based LP (LM-LP) in an outpatient neurology setting, performed by a single experienced provider.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective randomized controlled trial was conducted from 2017 to 2022. Patients requiring LP were randomized to either LM-LP or US-LP. Success was defined as obtaining cerebrospinal fluid (CSF) within three attempts. Secondary outcomes included procedure time, incidence of traumatic taps, and post-LP headache rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both techniques had comparable success rates, with LM-LP achieving 91% and US-LP 100% (<jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.05). Procedure time was significantly shorter for LM-LP (13 vs. 19\u202fmin, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). The incidence of traumatic taps and post-LP headaches was similar between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a general outpatient neurology population, LM-LP is as effective as US-LP and requires less time. While US-LP may be beneficial for high-risk patients (e.g., obesity, prior back surgery), further studies are needed to confirm its superiority in these populations.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1521783","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T09:00:13Z","timestamp":1741683613000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["\u2018UltraGUD LP\u2019\u2014ultrasound guided diagnostic LP\u2014a randomizedcontrolled trial. Traditional landmark based lumbar puncture is as effective as ultrasound guided lumbar puncture in outpatient neurology settings"],"prefix":"10.3389","volume":"16","author":[{"given":"Vijay","family":"Renga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte A.","family":"Jeffreys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsha","family":"Tabasum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"MacKenzie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.ajem.2006.08.013","article-title":"Emergency physicians can easily obtain ultrasound images of anatomical landmarks relevant to lumbar 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przypadk\u00f3w","volume":"45","author":"Duniec","year":"2013","journal-title":"Anestezjol Intensywna Ter"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1111\/acem.13558","article-title":"Ultrasound-assisted lumbar punctures: a systematic review and Meta-analysis","volume":"26","author":"Gottlieb","year":"2019","journal-title":"Acad Emerg Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1212\/CPJ.0000000000000725","article-title":"Ultrasound-guided lumbar puncture improves success rate and efficiency in overweight patients","volume":"10","author":"Li","year":"2020","journal-title":"Neurol Clin Pract"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"591","DOI":"10.12788\/jhm.3197","article-title":"Recommendations on the use of ultrasound guidance for adult lumbar puncture: a position statement of the Society of Hospital Medicine","volume":"14","author":"Soni","year":"2019","journal-title":"J Hosp Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1007\/s12630-013-9984-9","article-title":"Single-operator real-time ultrasound-guided spinal injection using SonixGPS\u2122: a case series","volume":"60","author":"Brinkmann","year":"2013","journal-title":"Can J Anesth Can Anesth"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1007\/s12630-015-0367-2","article-title":"Computerized training system for ultrasound-guided lumbar puncture on abnormal spine models: a randomized controlled trial","volume":"62","author":"Keri","year":"2015","journal-title":"Can. J. Anesth. Can. Anesth."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1521783\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T09:00:16Z","timestamp":1741683616000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1521783\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":16,"alternative-id":["10.3389\/fneur.2025.1521783"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1521783","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]},"article-number":"1521783"}}