Tags

Type your tag names separated by a space and hit enter

Intrathecal administration of nusinersen in adult and adolescent patients with spinal muscular atrophy and scoliosis: Transforaminal versus conventional approach.
Neuromuscul Disord 2019; 29(10):742-746ND

Abstract

Spinal deformities and surgical correction of scoliosis can make intrathecal delivery of nusinersen very challenging. We aim to evaluate the feasibility and safety of intrathecal administration of nusinersen either via interlaminar or transforaminal approach in a cohort of adult and adolescent patients with spinal muscular atrophy (SMA). Twelve patients were treated with nusinersen in our center under CT-guidance; after a CT scan of the lumbar column, we identified a safe virtual trajectory for the needle and defined patients to address to the transforaminal approach (seven patients) or the interlaminar approach (five patients). Out of 47 procedures, all injections but one were successful. There was one adverse event (post-lumbar puncture syndrome) in the interlaminar approach group (out of 20 procedures) and four adverse events in TFA group (out of 27 procedures) including one serious adverse event, a subarachnoid hemorrhage that required hospitalization. Transforaminal approach can be considered an effective option for nusinersen administration but potentially associated with serious complications, therefore it should be recommended in very selected patients.

Authors+Show Affiliations

Department of Neuroscience "Rita Levi Montalcini, University of Turin, Via Cherasco 15, 10126, Turin, Italy.Neuroradiological Unit, Department of Neuroscience, University of Turin (Molinette Hospital), Via Cherasco 15, 10126 Turin, Italy.Neuroradiological Unit, Department of Neuroscience, University of Turin (Molinette Hospital), Via Cherasco 15, 10126 Turin, Italy.Department of Neuroscience "Rita Levi Montalcini, University of Turin, Via Cherasco 15, 10126, Turin, Italy.Department of Neuroscience "Rita Levi Montalcini, University of Turin, Via Cherasco 15, 10126, Turin, Italy.Department of Pediatrics, Division of Child Neurology and Psychiatry, University of Turin, Piazza Polonia 94, 10126 Turin, Italy.Neuroradiological Unit, Department of Neuroscience, University of Turin (Molinette Hospital), Via Cherasco 15, 10126 Turin, Italy.Department of Neuroscience "Rita Levi Montalcini, University of Turin, Via Cherasco 15, 10126, Turin, Italy. Electronic address: tizianaenrica.mongini@unito.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31604650

Citation

Bortolani, Sara, et al. "Intrathecal Administration of Nusinersen in Adult and Adolescent Patients With Spinal Muscular Atrophy and Scoliosis: Transforaminal Versus Conventional Approach." Neuromuscular Disorders : NMD, vol. 29, no. 10, 2019, pp. 742-746.
Bortolani S, Stura G, Ventilii G, et al. Intrathecal administration of nusinersen in adult and adolescent patients with spinal muscular atrophy and scoliosis: Transforaminal versus conventional approach. Neuromuscul Disord. 2019;29(10):742-746.
Bortolani, S., Stura, G., Ventilii, G., Vercelli, L., Rolle, E., Ricci, F., ... Mongini, T. (2019). Intrathecal administration of nusinersen in adult and adolescent patients with spinal muscular atrophy and scoliosis: Transforaminal versus conventional approach. Neuromuscular Disorders : NMD, 29(10), pp. 742-746. doi:10.1016/j.nmd.2019.08.007.
Bortolani S, et al. Intrathecal Administration of Nusinersen in Adult and Adolescent Patients With Spinal Muscular Atrophy and Scoliosis: Transforaminal Versus Conventional Approach. Neuromuscul Disord. 2019;29(10):742-746. PubMed PMID: 31604650.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrathecal administration of nusinersen in adult and adolescent patients with spinal muscular atrophy and scoliosis: Transforaminal versus conventional approach. AU - Bortolani,Sara, AU - Stura,Guido, AU - Ventilii,Giancarlo, AU - Vercelli,Liliana, AU - Rolle,Enrica, AU - Ricci,Federica, AU - Bergui,Mauro, AU - Mongini,Tiziana, Y1 - 2019/08/23/ PY - 2019/02/25/received PY - 2019/06/18/revised PY - 2019/08/14/accepted PY - 2019/10/13/pubmed PY - 2019/10/13/medline PY - 2019/10/13/entrez KW - CT-guide KW - Intrathecal KW - Nusinersen KW - Spinal muscular atrophy SP - 742 EP - 746 JF - Neuromuscular disorders : NMD JO - Neuromuscul. Disord. VL - 29 IS - 10 N2 - Spinal deformities and surgical correction of scoliosis can make intrathecal delivery of nusinersen very challenging. We aim to evaluate the feasibility and safety of intrathecal administration of nusinersen either via interlaminar or transforaminal approach in a cohort of adult and adolescent patients with spinal muscular atrophy (SMA). Twelve patients were treated with nusinersen in our center under CT-guidance; after a CT scan of the lumbar column, we identified a safe virtual trajectory for the needle and defined patients to address to the transforaminal approach (seven patients) or the interlaminar approach (five patients). Out of 47 procedures, all injections but one were successful. There was one adverse event (post-lumbar puncture syndrome) in the interlaminar approach group (out of 20 procedures) and four adverse events in TFA group (out of 27 procedures) including one serious adverse event, a subarachnoid hemorrhage that required hospitalization. Transforaminal approach can be considered an effective option for nusinersen administration but potentially associated with serious complications, therefore it should be recommended in very selected patients. SN - 1873-2364 UR - https://www.unboundmedicine.com/medline/citation/31604650/Intrathecal_administration_of_nusinersen_in_adult_and_adolescent_patients_with_spinal_muscular_atrophy_and_scoliosis:_Transforaminal_versus_conventional_approach L2 - https://linkinghub.elsevier.com/retrieve/pii/S0960-8966(19)31083-1 DB - PRIME DP - Unbound Medicine ER -