The lumbar cistern is the enlarged part of the subarachnoid space below the end of the spinal cord, from about L2 to S2. It contains cerebrospinal fluid, the nerve roots of the cauda equina and the filum terminale. Because there is no spinal cord here, it is the safe site for a lumbar puncture.
| Location | Lower vertebral canal, from the conus medullaris (about L1-L2) to the end of the dural sac (about S2) |
|---|---|
| Parts |
|
| Connections |
|
| Blood Supply | Lumbar and lateral sacral arteries (radicular branches to the meninges) |
Holds cerebrospinal fluid around the lower nerve roots and provides an access point to sample CSF or give spinal anaesthesia.
Lumbar puncture is performed at L3-L4 or L4-L5, roughly level with a line joining the top of the iliac crests (Tuffier line). The floating nerve roots usually move away from the needle. Spinal anaesthetic injected here blocks the lower body. Lumbar drains placed in this cistern are used to divert CSF after surgery or in hydrocephalus testing.
A positional headache caused by continued CSF leakage through the dural hole after lumbar puncture.
Contamination of the CSF sample with blood from puncture of a small epidural or radicular vein during lumbar puncture.
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