A Closed-System Lumbar Puncture Design for Microgravity.

INTRODUCTION: A lumbar puncture (LP) is a diagnostic and therapeutic procedure for wide-ranging conditions terrestrially with additional applications in the microgravity environment of human spaceflight. LP has been performed on astronauts postflight in an attempt to answer lingering health questions, like the causes of spaceflight-associated neuro-ocular syndrome. However, an LP has not been performed in space or microgravity before due to the operational constraints of the procedure, including infection risk, air entrance, and fluid management difficulties in microgravity. This has prevented in-flight intracranial pressure measurements and important characterizations of cerebrospinal fluid (CSF) composition during spaceflight. METHODS: We developed a closed-system LP design by introducing an injection port between the typical needle-stylet LP device and using an electronic pressure transducer (eliminating gravity-based manometry). An initial proof of concept demonstration of the new device was conducted by performing mock LPs using an LP trainer with known fluid pressures. RESULTS: Closed-system LP was successfully demonstrated with no loss of fluid external to the system and no appreciable entrance of air. The new closed system showed accurate (r = 0.995) and precise (SD = 0.406 mmHg) results when measuring pressures in the typical CSF range of 8-15 mmHg. DISCUSSION: This initial demonstration serves as the first step in testing a novel LP system that mitigates risks of conducting the procedure during spaceflight. An in-flight LP would enable the collection of vital data on intracranial pressure and CSF composition under microgravity. Development of custom equipment and in vivo testing are needed for further validation. Adams B, Levinson Z, Alexandrov P, Mampre D. A closed-system lumbar puncture design for microgravity. Aerosp Med Hum Perform. 2026; 97(7):534-538.