Willard Scott,  Kaye Robin,  Schaefer Carrie,  Aria David

Final Pr. ID: Poster #: EDU-060

To describe alternative routes of Nusinersen administration in patients in whom traditional lumbar puncture is limited secondary to spinal hardware and bony fusion. Read More

Authors:  Willard Scott , Kaye Robin , Schaefer Carrie , Aria David

Keywords:  Spinraza, Spinal muscular atrophy SMA, nusinersen

Ortiz Carlos,  Chau Alex,  Desai Sudhen,  Kukreja Kamlesh

Final Pr. ID: Poster #: EDU-048

1) Reviewing the pathology and outcomes of children with spinal muscular atrophy (SMA)
2) Learning the procedures available for intrathecal access
3) Understanding the indications for choosing more advanced techniques to deliver nusinersen

Spinal muscular atrophy is an autosomal recessive disease affecting motor neurons and is the most common genetic cause of death in infants. Nuinersen (Spinraza) was recently approved by FDA for intrathecal administration in SMA patients. Commonly administered by lumbar puncture in the clinic or with imaging guidance, this is the initial method of administering nusinersen. Deformities and spinal instrumentation from orthopedic surgeries are common in SMA patients, preventing traditional intrathecal access by lumbar puncture for nusinersen delivery. Transforaminal lumbar sac access, ultrasound or fluoroscopy guided cervical spine access, or subcutaneous catheter placement can be the alternative approaches with failed/difficult lumbar access. Given the potential benefit of nusinersen, understanding all methods to obtain intrathecal access is essential for a pediatric interventional radiology (IR) practice. Read More

Authors:  Ortiz Carlos , Chau Alex , Desai Sudhen , Kukreja Kamlesh

Keywords:  nusinersen, spinal muscular atrophy, intrathecal administration

Patel Manish,  Weiss Judith,  Kandil Ali,  Johnson Neil

Final Pr. ID: Poster #: SCI-034

Patients with Spinal Muscular Atrophy (SMA) may have scoliosis requiring spinal hardware for spinal fixation. The scoliosis in addition to the spinal hardware makes intrathecal access difficult with conventional approaches. With recent FDA approval of nusinersen (SpinrazaÒ) for SMA, intrathecal access is required for administration of this meditation. We describe our experience in these patients using a variety of lumbar puncture approaches (intra-spinous process, trans-pedicle, and trans-foraminal) utilizing conventional fluoroscopy, cone-beam CT (CBCT) with fluoroscopy overlay and/or conventional CT with CT fluoroscopy. Approach to the type of access and image guidance is based on the presence of spinal hardware and degree of scoliosis and spinal fusion. Read More

Authors:  Patel Manish , Weiss Judith , Kandil Ali , Johnson Neil

Keywords:  Spinal Muscular Atrophy, Lumbar Puncture, Spinraza