A Systematic Review of Procedural Complications from Transforaminal Lumbar Puncture for Intrathecal Nusinersen Administration in Patients with Spinal Muscular Atrophy.

BACKGROUND

Spinal muscular atrophy is a progressive neurodegenerative disorder that can be treated with intrathecal antisense oligonucleotide therapy (nusinersen). However, administration is often complicated by posterior spinal fusion and neuromuscular scoliosis, necessitating a transforaminal approach.

PURPOSE

To assess the safety profile of the transforaminal approach for intrathecal access.

DATA SOURCES

Searches of the PubMed, Web of Science, and SCOPUS databases.

STUDY SELECTION

Thirteen articles were selected based on inclusion of transforaminal access and appropriate clinical information about the procedure.

DATA ANALYSIS

Complications were taken from the included articles and aggregated based on Cardiovascular and Interventional Radiological Society of Europe scale adverse event grading.

DATA SYNTHESIS

Total number of complications and grade of complications were analyzed, by year and in total.

LIMITATIONS

Selection bias in publication, small patient population size, and variability of the procedure limits the available data.

CONCLUSIONS

Transforaminal approach is a safe alternative for intrathecal access in patients with spinal muscular atrophy and may be applicable to a larger patient population.