J Pediatr Neurol
DOI: 10.1055/s-0039-1697583
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Transforaminal Intrathecal Access for Injection of Nusinersen in Adult and Pediatric Patients with Spinal Muscular Atrophy

1  Department of Radiology; Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
1  Department of Radiology; Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
Michael C. Hurley
1  Department of Radiology; Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
Pouya Nazari
1  Department of Radiology; Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
1  Department of Radiology; Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
Senda Ajroud-Driss
2  Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
Nancy Kuntz
3  Department of Pediatric Neurology, Lurie Children’s Hospital Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
Subhan Azmi
1  Department of Radiology; Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
Vamshi Rao
3  Department of Pediatric Neurology, Lurie Children’s Hospital Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
,
Ali Shaibani
1  Department of Radiology; Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
› Author Affiliations
Further Information

Publication History

22 May 2019

03 August 2019

Publication Date:
30 September 2019 (online)

Abstract

Purpose The main purpose of this article is to assess the safety and efficacy of transforaminal lumbar puncture for the injection of nusinersen (Spinraza) in patients with extensive spinal fusion and/or scoliosis.

Method A retrospective chart reviews of all spinal muscular atrophy patients (adults and children) were conducted. Demographic data, procedure details, follow-ups, and related complications were recorded.

Results We performed 85 transforaminal injections in nine pediatric patients (5 male and 4 female) aged between 8 and 17 years (mean = 11 years) and seven adult patients (5 females and 2 males) aged between 24 and 41 years (mean= 30 years). Fluoroscopy guidance was used in 87% of our patients. No major complication was reported.

Conclusion Fluoroscopy-guided transforaminal nusinersen injection is a safe and successful alternative approach in adult and pediatric patients with severe spinal scoliosis, interlaminar osseous fusion, and spinal fusion hardware.