Department of Diagnostic Radiology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, United States.
Department of Diagnostic Radiology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, United States.
J Clin Neurosci. 2020 Feb;72:114-118. doi: 10.1016/j.jocn.2019.12.056. Epub 2020 Jan 21.
Fluoroscopic-guided lumbar puncture (LP) is a procedure commonly performed by radiologists, which in some circumstances may be difficult or impossible using a traditional posterior interspinous or interlaminar approach. Alternatives to LP include cervical and cisternal punctures, placement of an Ommaya reservoir, and lumbar laminectomy. More recently, however, there has been a move toward access of the thecal sac through a transforaminal approach in patients with challenging anatomy. This report outlines our approach and experience using transforaminal LP (TFLP) in patients with spinal muscular atrophy (SMA) with a 100% success rate. We discuss its utility in other patients with difficult access and compare TFLP with other techniques to access the intrathecal space.
荧光引导下腰椎穿刺（LP）是放射科医生常进行的一项操作，在某些情况下，传统的后路棘突间或棘突间入路可能会变得困难或不可能。LP 的替代方法包括颈椎和小脑延髓池穿刺、放置 Ommaya 储液器以及腰椎椎板切除术。然而，最近，对于解剖结构具有挑战性的患者，通过经椎间孔入路进入硬脊膜囊的方法已经出现。本报告概述了我们在患有脊髓性肌萎缩症（SMA）的患者中使用经椎间孔腰椎穿刺（TFLP）的方法和经验，成功率为 100%。我们讨论了其在其他难以进入的患者中的应用，并将 TFLP 与其他进入蛛网膜下腔的技术进行了比较。
