{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T07:26:19Z","timestamp":1773386779341,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australas J Ultrason Med"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Purpose<\/jats:title>\n                    <jats:p>Nusinersen, the first treatment approved for all spinal muscular atrophy (SMA) types, is administered intrathecally through lumbar puncture. We used ultrasound assistance or a landmark\u2010based technique to access the lumbar intrathecal space in adult SMA patients. This study aimed to evaluate the technical success and adverse events (AEs) in such patients using either technique over a long observation period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty\u2010one adult patients received 507 consecutive interlaminar nusinersen administrations. Patients presented with both \u2018uncomplicated spines\u2019 or \u2018complicated spines\u2019; two patients had previous back surgery. Technical success and AEs were recorded using either technique. A generalised linear mixed model was applied to evaluate predictors of technical success and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>An overall success rate of 99.6%, with only two procedures failing to reach the intrathecal space, and an overall optimal procedure rate of 90.3% have been reported. A total of 455 procedures (89.7%) were uneventfully performed. One (0.2%) case of severe AE (puncture of a bulky abdominal annexal cyst) was recorded. Twenty\u2010seven episodes (5.3%) of post\u2010dural puncture headache (PDPH) and 24 episodes (4.7%) of radicular or back pain, both successfully treated with medical therapy, have also been reported. Technical success was significantly associated with \u2018complicated spines\u2019 (P\u2009=\u20090.022) and the use of ultrasound assistance (P\u2009=\u20090.01), and the use of ultrasound was the only independent predictor of uncomplicated procedures (P\u2009=\u20090.007).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In adult patients with SMA both landmark\u2010based and ultrasound\u2010assisted techniques are safe and effective even in the long term. The use of assistance is associated with technical success and can predict uncomplicated procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results support the use of ultrasonography in order to improve the success and reduce the burden of nusinersen intrathecal administration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajum.12401","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T12:43:34Z","timestamp":1721047414000},"page":"210-217","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ultrasound\u2010assisted and landmark\u2010based nusinersen delivery in spinal muscular atrophy adults: A retrospective analysis"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1312-5382","authenticated-orcid":false,"given":"Bruno Antonio","family":"Zanfini","sequence":"first","affiliation":[{"name":"Department of Emergency, Anesthesiological and Reanimation Sciences Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata Katia","family":"Patanella","sequence":"additional","affiliation":[{"name":"Centro Clinico NeMO Adulti Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Vassalli","sequence":"additional","affiliation":[{"name":"Obstetric Anesthesia, Department of Critical Care and Perinatal Medicine Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Catarci","sequence":"additional","affiliation":[{"name":"Department of Emergency, Anesthesiological and Reanimation Sciences Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika","family":"Pane","sequence":"additional","affiliation":[{"name":"Centro Clinico NeMO Pediatrico Fondazione Policlinico Universitario A Gemelli IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciano","family":"Frassanito","sequence":"additional","affiliation":[{"name":"Department of Emergency, Anesthesiological and Reanimation Sciences Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Biancone","sequence":"additional","affiliation":[{"name":"Department of Emergency, Anesthesiological and Reanimation Sciences Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1070-4955","authenticated-orcid":false,"given":"Mariangela","family":"Di Muro","sequence":"additional","affiliation":[{"name":"Department of Emergency, Anesthesiological and Reanimation Sciences Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Bravetti","sequence":"additional","affiliation":[{"name":"Centro Clinico NeMO Pediatrico Fondazione Policlinico Universitario A Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenio Maria","family":"Mercuri","sequence":"additional","affiliation":[{"name":"Centro Clinico NeMO Pediatrico Fondazione Policlinico Universitario A Gemelli IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Sabatelli","sequence":"additional","affiliation":[{"name":"Centro Clinico NeMO Adulti Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"},{"name":"Obstetric Anesthesia, Department of Critical Care and Perinatal Medicine Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini  Genoa Italy"},{"name":"Centro Clinico NeMO Pediatrico Fondazione Policlinico Universitario A Gemelli IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Draisci","sequence":"additional","affiliation":[{"name":"Department of Emergency, Anesthesiological and Reanimation Sciences Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"},{"name":"Centro Clinico NeMO Adulti Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"},{"name":"Obstetric Anesthesia, Department of Critical Care and Perinatal Medicine Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini  Genoa Italy"},{"name":"Centro Clinico NeMO Pediatrico Fondazione Policlinico Universitario A Gemelli IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Commissioner of the FDA approves first drug for spinal muscular atrophy.2019. Available from:http:\/\/www.fda.gov\/news\u2010events\/press\u2010announcements\/fda\u2010approves\u2010first\u2010drug\u2010spinal\u2010muscular\u2010atrophy."},{"key":"e_1_2_9_3_1","unstructured":"Summary of the European public assessment report (EPAR) Spinraza. Available from:https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/spinraza#product\u2010information\u2010section."},{"key":"e_1_2_9_4_1","first-page":"562","article-title":"Pharmacokinetics of phosphonothioate antisense oligodeoxynucleotides","volume":"2","author":"Geary RS","year":"2001","journal-title":"Curr Opin Investig Drugs"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60921-6"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001247"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0000000000000333"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000519831"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.2.SPINE181366"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2019.08.007"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2020.19607"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2020-016058"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1718916"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14586"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27518"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-021-01903-4"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27400"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31821a8ad4"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2010.04.002"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001325"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000911"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199703000-00021"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000320447.61835.EA"},{"key":"e_1_2_9_24_1","unstructured":"Spinraza\u2010prescribing\u2010information.pdf. Available from:https:\/\/www.spinraza.com\/content\/dam\/commercial\/specialty\/spinraza\/caregiver\/en_us\/pdf\/spinraza\u2010prescribinginformation.pdf."},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2017.06.019"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006502"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1710504"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2009965"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028020914274"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-021-02065-z"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51514"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5596"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2014\/17\/277"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-019-02189-x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13500"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756286419887616"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004600"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13558"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2020.12.006"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30037-5"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.2478\/raon-2022-0033"},{"key":"e_1_2_9_42_1","volume-title":"Anatomy, back, spinal meninges","author":"Sehgal I","year":"2022"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009914"}],"container-title":["Australasian Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajum.12401","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ajum.12401","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajum.12401","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T03:01:49Z","timestamp":1773370909000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajum.12401"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1002\/ajum.12401"],"URL":"https:\/\/doi.org\/10.1002\/ajum.12401","archive":["Portico"],"relation":{},"ISSN":["1836-6864","2205-0140"],"issn-type":[{"value":"1836-6864","type":"print"},{"value":"2205-0140","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]},"assertion":[{"value":"2024-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}