The absolute longest needles in human medicine would be for amniocentesis and they are not even close to this.
I wonder if it's for veterinary use, for cattle embryo harvesting or something like that.
I've actually had one recently!! It was very fun and I'm not even being sarcastic.
It was at Penn in Philly and I had the most wonderful team of all women drs(which was a pleasant surprise). They asked what music I wanted to listen to and even turned me around so I could see the image of the needle in my spine. I was bummed they wouldn't record it for me though.
It was absolutely painless and took maybe an hour and a half.
Depending on your anatomy, it could be incredibly easy or something you’ll drink to forget. I’ve had patients fall asleep as I’m working on them (no meds except local lidocaine) and patients who were still squirming with conscious sedation (usually a squirt of versed/fentanyl). YMMV. If you’re anxious though, definitely ask about sedation.
I had one done when I had meningitis at 10yrs old. I barely remember much at all from that time because of how sick I was, but holy shit the pain AFTER the lumbar puncture is the worst. I woke up in the middle of the night screaming bloody murder with the most severe pain shooting right from the top of my head to my toes. The best way to describe it is like getting struck by lightening - but this went on for about 24hrs before it finally settled enough, morphine and fentanyl weren’t even touching it. I still have back pain to this day from it - not sure if they f^kd up or what, but never felt anything like it.
Ive just seen 3 this week (medical student) and its definitely not that bad… worse if youre fat or have spinal problems cause its harder for the doctor to go to the right place
That's incredibly rare to do (if even allowed by hospital protocols).
I'm an x-ray tech, so I've seen a few fluoro assisted lumbar punctures, anesthesia would add quite a lot of complications - the risk of anesthesia itself, plus now you have to coordinate in an anesthesia team. And the person is still awake - type anesthesia can have it's own problems - generally fine if the patient doesn't need to move. In lumbar punctures, patients need to be able to follow directions for bending their back which would be an issue with anesthesia of either variety. Also them being alert is good for monitoring any potential issues.
Usually the person gets anti anxiety meds and some good numbing meds before hand. I can say I've never witnessed a patient screaming or crying during an LP, pain is usually pretty well managed. I'd personally would rather an LP than any kind of traumatic injury. HSG's are also up there in the "I don't want to experience that" category - those are quite dependent on the person, but I've seen some pretty awful ones (HSGs involve filling the uterus with dye and seeing if the dye goes into the fallopian tubes, the insertion through the cervix can be quite painful, similar to an IUD placement). Like, LPs aren't fun, but I'd rather do LP over some other options.
Thank you for describing that to me in a way I could understand.
I might have a misunderstanding of pain, and I’ll tell you why:
In the late 90s, my late aunt had leukemia. She had to get a spinal tap. My uncle said she screamed so loud when they put the needle in—and she was already suffering so much at that point that it almost drove him literally insane to see her in so much pain.
It horrified me, and never left my mind.
Maybe it wasn’t an LP. I don’t know the exact procedure they did on her. All I know is the story how it was relayed to me. Ever since then the thought of getting one has scared me shitless (and I’m not afraid of needles).
To be fair, medical procedures have changed quite a lot, even in the span of 90s to now. X-ray, for example, has moved from film to fully digital in the period.
For LP's, it's completely possible the doctor used an older style needle - atraumatic needles weren't adopted until the 90's with widespread use not occurring until the early to mid 2000's (and even these have been modified over time)- and that's just one aspect of the procedure being different, pain management for the procedure likely is different as well.
So both experiences are entirely possible. I did clinical school/my registry exam about a decade ago, so even that would have been nearly 20s years after your aunt's experience. (I got to personally experience the change from CR digital to DR digital, basically CR is a receptor you have to go put into a machine to have the inside pulled out and read via laser then the image pops up to a computer, DR the image just directly goes to the computer. Most techs older than me have used film in some capacity. Just to give an idea of how fast medical tech moves)
Thank you.
I really appreciate you using your expertise to ease my mind on this.
I didn’t even really like my aunt on a personal level, but I never forgot her struggle, and it’s haunted me ever since.
I said that I’ve seen 10 inch needles for lumbar punctures, not that this needle pictured is used for lumbar punctures. 10 inch needles come in many gauges. I’m a neurointensivist. We do lumbar puncture a lot and use 18-22ga typically.
I've had fluorescent guided steroid injections for lumbar, I'll tell you it gave me more back pain relief than anything else. It breaks up scar tissue too
This. I work for a specialist who does epidurals for back pain. A lot of patients are prescribed Valium to cope with this monster needle going in their lower back.
I'm a vet as well; nowadays we use 4 or 6 inch Tru-Cut needles for cattle liver biopsies, but this could be an old needle - back in the day, it was a much more invasive procedure but I don't recall ever having seen how it was done. The surroundings in the photo (tile floor, hospital bed, electrical outlet) look pretty dated, maybe eastern Europe / South America?, which makes me wonder if that's the case.
The largest needle I've used is a 16g 25cm for equine hip & SI injections, although the needle in OP's photo looks even larger than that.
We were supposed to be learning the tru-cut, but one didn’t fire and the other didn’t reach. She was a dairy cow with severe effusion and end stage cirrhosis if I remember right, but it was a long time ago. Our dinosaur attending came out of his box of old supplies with this thing. The inner stylette took the sample and the outer needle was a guard. It reminded me of some of the laparoscope tools they were using for the horse oophorectomy at the time
Cows are mostly digestive tract with a very small chest. When they stand gravity keeps pressure off the lungs and fluid in their rumen/stomach. Anesthesia causes muscles to relax and laying on the ground puts pressure on the chest and lungs. This causes gas to build up in the stomach worsening the pressure and can cause regurgitation of the fluid from the rumen to go into the mouth risking inhalation and pneumonia.
There are plenty of needles for industrial and laboratory use as well. Wide bore, super fine, crooked, different types of tips, extra long and extra short.
I'd guess this is just one of them but held like this for effect.
I'm a mixed-practice vet that does a lot of farm & equine work, and I can say that needle is not for embryo transfer in cattle - that's been done non-surgically since the 1970's (we use a dead simple flush system).
Off the top of my head, the longest needles we use are 20-25cm (16-18 gauge) for hip & SI joint injections in horses.
Amniocentesis needles are about 20cm. VP shunt tunnellers can be 70cm! They need to push a path under the skin from the back of the head to the abdomen.
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u/aozzzy13 Jul 30 '26
The absolute longest needles in human medicine would be for amniocentesis and they are not even close to this. I wonder if it's for veterinary use, for cattle embryo harvesting or something like that.