{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T03:32:27Z","timestamp":1771471947154,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T00:00:00Z","timestamp":1645574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Previous papers on ultrasound (US)\u2010guided delivery of nusinersen in patients with spinal muscle atrophy (SMA) described good results with translaminar approach. However, this approach is not possible in patients with spinal fusion and no visible interlaminar space on pre\u2010procedural computed tomography (CT). US\u2010guided transforaminal nusinersen delivery is a potential option that warrants investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty adult SMA patients with challenging access were treated in our institution under cone beam CT (CBCT) guidance. The patients were already in the maintenance phase of the dosing protocol and were prospectively evaluated for US\u2010guided transforaminal approach. After they completed one injection via US\u2010guided transforaminal approach, success and safety of the approach were analyzed. Patients shared their experience on US\u2010guided in comparison to CBCT\u2010guided injections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>US\u2010guided transforaminal puncture was possible in 14 (70.0%) patients, although 2 of them required needle repositioning under fluoroscopy due to inadvertent access of a prominent vein. US\u2010guided transforaminal approach was therefore successful in 60% of patients. Mild adverse events were recorded in four patients. The survey on patients' experience showed that seven reported no difference in the two approaches, six preferred the US\u2010guided procedure, and one preferred the CBCT\u2010guided procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>US\u2010guided transforaminal lumbar approach is an effective and safe method of intrathecal nusinersen delivery in adult SMA patients with challenging spinal access and could be considered the first option in appropriately selected adult SMA patients requiring transforaminal nusinersen delivery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27518","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T09:27:47Z","timestamp":1644571667000},"page":"585-589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Ultrasound\u2010guided transforaminal approach for nusinersen delivery in adult spinal muscle atrophy patients with challenging access"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6864-8880","authenticated-orcid":false,"given":"\u017diga","family":"Snoj","sequence":"first","affiliation":[{"name":"Radiology Institute University Medical Centre Ljubljana  Ljubljana Slovenia"},{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladka","family":"Salapura","sequence":"additional","affiliation":[{"name":"Radiology Institute University Medical Centre Ljubljana  Ljubljana Slovenia"},{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-018-4240-7"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14586"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-021-01903-4"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000184"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40981-020-00367-y"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27400"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5596"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2020-016058"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2019.08.007"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-017-4031-6"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2021.02.009"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-7161-5-4"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-7161-3-16"},{"issue":"1","key":"e_1_2_11_15_1","first-page":"19","article-title":"Adolescent idiopathic scoliosis: common questions and answers","volume":"101","author":"Kuznia AL","year":"2020","journal-title":"Am Fam Physician"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2017.06.019"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.01166"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1713119"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-018-5474-3"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27116"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27518","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mus.27518","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27518","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T20:08:04Z","timestamp":1692994084000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.27518"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,23]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1002\/mus.27518"],"URL":"https:\/\/doi.org\/10.1002\/mus.27518","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,23]]},"assertion":[{"value":"2021-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}