ArticlePediatric radiology2018
Transforaminal intrathecal delivery of nusinersen using cone-beam computed tomography for children with spinal muscular atrophy and extensive surgical instrumentation: early results of technical success and safety.
Article in Pediatric radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 55 citations in OpenAlex.
- Article
- Assessment of motor function and nutritional status in children with spinal muscular atrophy treated with nusinersen after loading period in Western China: a retrospective study.BMC neurology · 2023Article
- Transforaminal lumbar puncture for spinal anesthesia or novel drug administration: a technique combining C-arm fluoroscopy and ultrasound.Regional anesthesia and pain medicine · 2022Article
- Therapy development for spinal muscular atrophy: perspectives for muscular dystrophies and neurodegenerative disorders.Neurological research and practice · 2022Review
- Disease Modifying Therapies for the Management of Children with Spinal Muscular Atrophy (5q SMA): An Update on the Emerging Evidence.Drug design, development and therapy · 2022Review
- Scoliosis Orthopedic Surgery Combined With Nusinersen Intrathecal Injection Significantly Improved the Outcome of Spinal Muscular Atrophy Patient: A Case Report.Frontiers in neurology · 2022Article
- Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Improves the Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Biopsy for Peripheral Pulmonary Lesions.Diagnostics (Basel, Switzerland) · 2021Article
- Intrathecal catheter and port placement for nusinersen infusion in children with spinal muscular atrophy and spinal fusion.Pediatric radiology · 2021Article
- Ultrasound-guided nusinersen administration for spinal muscular atrophy patients with severe scoliosis: an observational study.Orphanet journal of rare diseases · 2021Observational
- Ultra-low radiation dose protocol for CT-guided intrathecal nusinersen injections for patients with spinal muscular atrophy and severe scoliosis.Neuroradiology · 2021Article
- Ultrasound-assisted intrathecal injection of nusinersen in a patient with severe vertebral deformity: a case report.JA clinical reports · 2020Article
- Intrathecal administration of nusinersen for spinal muscular atrophy: report of three cases with severe spinal deformity.JA clinical reports · 2020Article
- Intrathecal nusinersen administration in adult spinal muscular atrophy patients with complex spinal anatomy.Therapeutic advances in neurological disorders · 2020Article
- Simple Fluoroscopy-Guided Transforaminal Lumbar Puncture: Safety and Effectiveness of a Coaxial Curved-Needle Technique in Patients with Spinal Muscular Atrophy and Complex Spines.AJNR. American journal of neuroradiology · 2020Article
- The Complex Spine in Children with Spinal Muscular Atrophy: The Transforaminal Approach-A Transformative Technique.AJNR. American journal of neuroradiology · 2019Article
- Ultrasound-guided cervical puncture for nusinersen administration in adolescents.Pediatric radiology · 2019Article
- Intrathecal administration of nusinersen in adolescent and adult SMA type 2 and 3 patients.Journal of neurology · 2019Article
- C1 Posterior Arch Flare Point: A Useful Landmark for Fluoroscopically Guided C1-2 Puncture.AJNR. American journal of neuroradiology · 2018Article
- Cone beam computed tomography-guided transpterygoidal aspiration of a carotid space abscess in Lemierre's syndrome.Radiology case reports · 2018Article
- Transforaminal Lumbar Puncture: An Alternative Technique in Patients with Challenging Access.AJNR. American journal of neuroradiology · 2018Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNusinersen, the only treatment approved by the United States Food and Drug Administration for spinal muscular atrophy (SMA), is delivered intrathecally. Many children with SMA have extensive spinal instrumentation and deformities, often precluding the use of standard approaches for gaining intrathecal access. Furthermore the anatomical distortion that often occurs with rotoscoliosis can complicate the use of fluoroscopic guidance. Compared to fluoroscopy, CT affords superior guidance for complex needle placements. This opens up alternatives to the posterior (interlaminar) technique, including transforaminal and caudal approaches.
objectiveThis study describes the early results of technical success, complications and radiation dose of intrathecal delivery of nusinersen using cone-beam CT guidance with two-axis fluoroscopic navigational overlay. MATERIALS AND
methodsWe conducted a retrospective review of 15 consecutive nusinersen injections performed in four children with SMA and extensive spinal hardware precluding standard posterior lumbar puncture techniques. These children were treated using transforaminal thecal access employing cone-beam CT with navigational overlay. We analyzed results including technical success, complications and total fluoroscopy time.
resultsAll procedures were technically successful. No major complications and one minor complication were reported; the minor complication was a post-procedural neuropathic headache that was attributed to procedural positioning and was treated successfully with gabapentin. The average procedural fluoroscopy time and air kerma were 1.9 min and 55.8 mGy, respectively.
conclusionCone-beam CT guidance with two-axis navigational overlay is a safe, effective method for gaining transforaminal intrathecal access in children with spinal abnormalities and hardware precluding the use of standard techniques.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.