Transverse interlaminar ultrasound-guided C1-C2 puncture for the intrathecal administration of nusinersen in patients with spinal muscular atrophy.

IF 2.8 3区医学 Q2 CLINICAL NEUROLOGY

Muscle & Nerve Pub Date : 2024-07-25 DOI:10.1002/mus.28212

Qing Yuan, Xulei Cui, Jiao Zhang, Yi Dai, Feng Feng, Yuguang Huang, Shuyang Zhang

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Abstract

Introduction/aims: Severe spinal deformities and previous spinal orthopedic instrumentation may result in substantial technical challenges for nusinersen delivery through lumbar puncture in patients with spinal muscular atrophy (SMA). The aim of this paper was to review our experience with ultrasound-guided cervical puncture as an alternative approach for the intrathecal administration of nusinersen.

Methods: This was a retrospective medical record review of transverse interlaminar ultrasound-guided C1-C2 puncture for nusinersen delivery in SMA patients. The details of puncture, complications, and success rate of the procedure were summarized.

Results: There were four patients who received a total of 13 cervical punctures for nusinersen delivery. All procedures were technically successful with no major complications. Full doses of nusinersen were delivered intrathecally.

Discussion: Transverse interlaminar ultrasound-guided C1-C2 puncture is an alternative approach for administering nusinersen if lumbar puncture fails. The success of the technique requires a thorough preprocedural evaluation of cervical spine imaging, sound knowledge of the cervical sonoanatomy and careful manipulation of the needle.

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在横向层间超声引导下进行 C1-C2 穿刺，为脊髓性肌肉萎缩症患者鞘内注射奴西那生。

简介/目的：脊髓肌肉萎缩症（SMA）患者严重的脊柱畸形和既往的脊柱矫形器械可能会给通过腰椎穿刺给药带来巨大的技术挑战。本文旨在回顾我们在超声引导下将颈椎穿刺作为鞘内注射奴西那生的替代方法的经验：这是一项回顾性病历审查，审查了在横向层间超声引导下为 SMA 患者进行 C1-C2 穿刺以给药 nusinersen 的情况。对穿刺的细节、并发症和手术成功率进行了总结：结果：4 名患者共接受了 13 次宫颈穿刺，以输送奴西能森。所有手术在技术上都很成功，没有出现重大并发症。讨论：讨论：如果腰椎穿刺失败，横向层间超声引导的 C1-C2 穿刺是给予奴西那生的另一种方法。这项技术的成功需要在术前对颈椎成像进行全面评估，对颈椎声像解剖有充分了解，并小心操作穿刺针。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Muscle & Nerve 医学-临床神经学

CiteScore

6.40

自引率

5.90%

发文量

287

审稿时长

3-6 weeks

期刊介绍： Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.

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