Pediatr Radiol (2018) 48:392–397 https://doi.org/10.1007/s00247-017-4031-6 ORIGINAL ARTICLE 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 1 2 1 3 John J. Weaver & Niranjana Natarajan & Dennis W. W. Shaw & Susan D. Apkon & 1 1 1 Kevin S. H. Koo & Giri M. Shivaram & Eric J. Monroe Received: 2 September 2017 /Revised: 15 October 2017 /Accepted: 3 November 2017 /Published online: 13 November 2017 Springer-Verlag GmbH Germany, part of Springer Nature 2017 Abstract were treated using transforaminal thecal access employing Background Nusinersen, the only treatment approved by the cone-beam CT with navigational overlay. We analyzed results United States Food and Drug Administration for spinal mus- including technical success, complications and total fluoros- cular atrophy (SMA), is delivered intrathecally. Many children copy time. with SMA have extensive spinal instrumentation and defor- Results All procedures were technically successful. No major mities, often precluding the use of standard approaches for complications and one minor complication were reported; the gaining intrathecal access. Furthermore the anatomical distor- minor complication was a post-procedural neuropathic head- tion that often occurs with rotoscoliosis can complicate the
Pediatric Radiology – Springer Journals
Published: Nov 13, 2017
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