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In Reply: Dr Vachon suggests that unequal medical care, rather than anatomic variations in bone structure, explains the higher risk for traumatic LP in black children. Indeed, inadequate access to health care and a poor socioeconomic status are known risk factors for inferior clinical outcomes among underprivileged groups in many settings.^1-2 We have observed more pronounced lumbar lordosis in black compared with white children during our practice and believe that its relationship to traumatic or bloody LPs warrants closer study.

We do not concur with Vachon that racial disparity in medical care was a major risk factor in the development of this complication. Patients are accepted for treatment at our nonprofit research hospital regardless of race, ethnicity, religion, or ability to pay. Each newly diagnosed patient is seen by an oncologist whose assignment to the case is based on a preset rotation. A designated practitioner, also assigned on a rotating . . . [Full Text of this Article]

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Racial Differences in Rates of Traumatic Lumbar Puncture
Gregory C. Vachon
JAMA. 2003;289(5):548.
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