Ultrasound-guided interlaminar approach for nusinersen administration in patients with spinal muscular atrophy with spinal fusion or severe scoliosis

Orphanet Journal of Rare Diseases

Research

Jianxing Qiu¹  Zhaoxia Wang²  Lingchao Meng²  Shan Liu³  Ying Wu³  Cuijie Wei³  Shuang Li³  Xinhua Bao⁴  Hui Xiong⁴  Chunde Li⁵  Luzeng Chen⁶  Zhenwei Liang⁶ 

[1] Department of Neurology, Peking University First Hospital, 100034, Beijing, China;Department of Orthopedic/Spine Surgery, Peking University First Hospital, 100034, Beijing, China;Department of Pediatrics, Peking University First Hospital, No. 1, Xi’anmen Street, West District, 100034, Beijing, China;Department of Pediatrics, Peking University First Hospital, No. 1, Xi’anmen Street, West District, 100034, Beijing, China;Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, 100034, Beijing, China;Department of Radiology, Peking University First Hospital, 100034, Beijing, China;Department of Ultrasonography, Peking University First Hospital, No. 7, Xishiku Street, West District, 100034, Beijing, China;

关键词: Ultrasound guidance;    Spinal muscular atrophy;    Spinal fusion;    Scoliosis;    Nusinersen;   

DOI  :  10.1186/s13023-023-02630-8

 received in 2022-08-22, accepted in 2023-02-06,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIntrathecal injection of medications can be challenging in spinal muscular atrophy (SMA) patients with severe scoliosis or after spine surgery. Here we report our experience with real-time ultrasound (US)-guided intrathecal administration of nusinersen in patients with SMA.MethodsSeven patients (six children and one adult) with either spinal fusion or severe scoliosis were enrolled. We performed intrathecal injections of nusinersen under US guidance. The efficacy and safety of US-guided injection were explored.ResultsFive patients had undergone spinal fusion, while the other two presented severe scoliosis. Success was achieved in 19/20 lumbar punctures (95%), 15 of which were performed through the near-spinous process approach. The intervertebral space with a designated channel was selected for the five postoperative patients, while the interspaces with the smallest rotation angle were chosen for the other two patients with severe scoliosis. In 89.5% (17/19) of the punctures, the number of insertions was no more than two. No major adverse events were observed.ConclusionGiven its safety and efficacy, real-time US guidance is recommended for SMA patients with spine surgery or severe scoliosis, and the near-spinous process view can be used as a interlaminar puncture approach for US guidance.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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