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

脊髓性肌萎缩症患者经椎间孔腰椎穿刺鞘内注射诺西那生治疗的手术并发症系统评价

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Abstract

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.

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