Transforaminal intrathecal delivery of nusinersen using cone-beam computed tomography for children with spinal muscular atrophy and extensive surgical instrumentation: early results of technical success and safety.

Abstract:

BACKGROUND:Nusinersen, the only treatment approved by the United States Food and Drug Administration for spinal muscular atrophy (SMA), is delivered intrathecally. Many children with SMA have extensive spinal instrumentation and deformities, often precluding the use of standard approaches for gaining intrathecal access. Furthermore the anatomical distortion that often occurs with rotoscoliosis can complicate the use of fluoroscopic guidance. Compared to fluoroscopy, CT affords superior guidance for complex needle placements. This opens up alternatives to the posterior (interlaminar) technique, including transforaminal and caudal approaches. OBJECTIVE:This study describes the early results of technical success, complications and radiation dose of intrathecal delivery of nusinersen using cone-beam CT guidance with two-axis fluoroscopic navigational overlay. MATERIALS AND METHODS:We conducted a retrospective review of 15 consecutive nusinersen injections performed in four children with SMA and extensive spinal hardware precluding standard posterior lumbar puncture techniques. These children were treated using transforaminal thecal access employing cone-beam CT with navigational overlay. We analyzed results including technical success, complications and total fluoroscopy time. RESULTS:All procedures were technically successful. No major complications and one minor complication were reported; the minor complication was a post-procedural neuropathic headache that was attributed to procedural positioning and was treated successfully with gabapentin. The average procedural fluoroscopy time and air kerma were 1.9 min and 55.8 mGy, respectively. CONCLUSION:Cone-beam CT guidance with two-axis navigational overlay is a safe, effective method for gaining transforaminal intrathecal access in children with spinal abnormalities and hardware precluding the use of standard techniques.

journal_name

Pediatr Radiol

journal_title

Pediatric radiology

authors

Weaver JJ,Natarajan N,Shaw DWW,Apkon SD,Koo KSH,Shivaram GM,Monroe EJ

doi

10.1007/s00247-017-4031-6

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

392-397

issue

3

eissn

0301-0449

issn

1432-1998

pii

10.1007/s00247-017-4031-6

journal_volume

48

pub_type

杂志文章
  • Sonographic findings of testicular teratoma with pathologic correlation.

    abstract::Testicular teratoma is a rare tumor in children. We recently encountered two boys, aged 18 months and 2 years respectively, with this tumor. Sonography revealed an intratesticular mass in both. The first revealed a predominantly cystic lesion with echogenic components along its wall. The second showed a complex mass o...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02011304

    authors: Liu P,Phillips MJ,Edwards VD,Ein S,Daneman A

    更新日期:1992-01-01 00:00:00

  • Ct in the surveillance and current control of children with extracranial malignant tumours.

    abstract::The clinical value of computerized body tomography (CT) was analysed in 221 consecutive examinations performed in the evaluation and surveillance of 74 children with various types of extracranial solid malignant tumours. CT was performed as part of a routine diagnostic reassessment in 104 cases and was clinically indi...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF00999310

    authors: Damgaard-Pedersen K,Yssing M

    更新日期:1982-01-01 00:00:00

  • Closed reduction with CT-guided screw fixation for unstable sacroiliac joint fracture-dislocation.

    abstract:BACKGROUND:Unstable posterior pelvic ring fractures and dislocations are uncommon but potentially life-threatening injuries in children. Early definitive management reduces risk of immediate complications as well as chronic pain and gait dysfunction. Conventional operative therapy carries substantial risk of extensive ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-004-1291-8

    authors: Baskin KM,Cahill AM,Kaye RD,Born CT,Grudziak JS,Towbin RB

    更新日期:2004-12-01 00:00:00

  • Short-limb skeletal dysplasias and craniosynostosis: what do they have in common?

    abstract::Fibroblast growth factor receptor mutations cause some of the main short-limb skeletal dysplasias and craniosynostosis syndromes, including achondroplasia, hypochondroplasia, thanatophoric dysplasia, Apert syndrome, Crouzon syndrome, Pfeiffer syndrome, and Jackson-Weiss syndrome. Much work remains to be done in unrave...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s002470050165

    authors: Cohen MM Jr

    更新日期:1997-05-01 00:00:00

  • Correction to: Chest computed tomography angiography in children on extracorporeal membrane oxygenation (ECMO).

    abstract::The published version of this article incorrectly lists the authors' affiliations. The correct affiliations are given below. The Publisher regrets this mistake. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,已发布勘误

    doi:10.1007/s00247-017-4064-x

    authors: Hull NC,Schooler GR,Binkovitz LA,Williamson EE,Araoz PA,Yu L,Young PM

    更新日期:2018-07-01 00:00:00

  • Delayed presentation of a caecal haematoma initially managed as appendicitis.

    abstract::A 15-year-old boy with caecal haematoma required a right hemicolectomy due to development of small bowel obstruction and near caecal perforation having presented several days after an episode of minor trauma. The position of the caecum between intraperitoneal and extraperitoneal bowel requires special treatment consid...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-013-2754-6

    authors: Oates AJ,Sutcliffe J,Stahlschmidt J,Kraft JK

    更新日期:2014-01-01 00:00:00

  • Sporadic idiopathic acroosteolysis with cranio-skeletal dysplasis, polycystic kidneys and glomerulonephritis. A case of the Hajdu-Cheney syndrome.

    abstract::A case of the Hajdu-Cheney syndrome in a 15 year old boy is described. The manifestations were: 1. isiopathic progressive acro-osteotions; 2. mutiple cranio-skeletal abnormalities; and 3. polycystic kidneys complicated by a rapidly progressive glomerulonephritis. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF00973535

    authors: Rosenmann E,Penchas S,Cohen T,Aviad I

    更新日期:1977-09-01 00:00:00

  • Complicated pleural tuberculosis in children: CT evaluation.

    abstract:PURPOSE:To describe the CT features of complicated pleural tuberculosis in children and to define the use of CT in children with pleural tuberculosis. MATERIALS AND METHODS:The CT findings in 11 children with complicated pleural tuberculosis were retrospectively analysed. CT was performed to evaluate persistent pleura...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s002470050561

    authors: Moon WK,Kim WS,Kim IO,Im JG,Kim JH,Yeon KM,Han MC

    更新日期:1999-03-01 00:00:00

  • Endobronchial carcinoid in a child: depiction with three-dimensional volume rendering.

    abstract::Endobronchial carcinoid is an extremely rare neoplasm in children. We report a case in which this entity was prospectively diagnosed by 3-D CT bronchography with volume rendering techniques. The ability to prospectively implicate an endobronchial neoplasm in a child may help to guide subsequent therapy and management....

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-004-1293-6

    authors: Connor GF,Fishman EK

    更新日期:2004-12-01 00:00:00

  • MR appearances of bone marrow in children following bone marrow transplantation.

    abstract::Two cases are presented of children who demonstrated complete absence of bone marrow signal on MR imaging of the spine following bone marrow transplantation. The possible causes for these appearances are discussed. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02018628

    authors: Boothroyd AE,Sebag G,Brunelle F

    更新日期:1991-01-01 00:00:00

  • The role of MRI in the evaluation of the fetal brain with an emphasis on biometry, gyration and parenchyma.

    abstract::The aim of this review is to emphasize the role of fetal MR in the evaluation of the supratentorial space. The advantages of MRI compared to US are stressed in three fields of application: cerebral biometry, sulcation and cerebral parenchyma. In each field, normal data are displayed and MR applications with patterns o...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-004-1249-x

    authors: Garel C

    更新日期:2004-09-01 00:00:00

  • Radiological abnormalities associated with anomalies of the ninth chromosome.

    abstract::The clinical and radiological features of Trisomy of the short arm of the ninth chromosome and of the Nail Patella Syndrome, both of which conditions are related to abnormalities of the ninth chromosome, are compared. Dislocation of the head of radius is seen in both conditions, as is a diminished patello condylar rat...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF00975540

    authors: Pilling DW,Levick RK

    更新日期:1978-02-28 00:00:00

  • Effective dose estimation in whole-body multislice CT in paediatric trauma patients.

    abstract:BACKGROUND:The number of multislice CT (MSCT) scans performed in polytraumatized children has increased rapidly. There is growing concern regarding the radiation dose in MSCT and its long-term consequences, especially in children. OBJECTIVE:To determine the effective dose to polytraumatized children who undergo whole-...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-008-1091-7

    authors: Munk RD,Strohm PC,Saueressig U,Zwingmann J,Uhl M,Südkamp NP,Kotter E,Langer M,Bley TA

    更新日期:2009-03-01 00:00:00

  • Surveillance magnetic resonance imaging for isolated optic pathway gliomas: is gadolinium necessary?

    abstract:BACKGROUND:Pediatric optic pathway gliomas are typically indolent but have a variable clinical course. Treatment is dictated by symptoms and changes on contrast-enhanced MRI examinations. Gadolinium retention in children has motivated parsimonious use of gadolinium-based contrast agents. OBJECTIVES:To determine survei...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-018-4154-4

    authors: Maloney E,Stanescu AL,Perez FA,Iyer RS,Otto RK,Leary S,Steuten L,Phipps AI,Shaw DWW

    更新日期:2018-09-01 00:00:00

  • Patterson-Lowry rhizomelic dysplasia: a potentially lethal bone dysplasia?

    abstract::We report a Japanese boy, who is considered as having Patterson-Lowry rhizomelic dysplasia, a rare, as yet undefined, skeletal dysplasia. The diagnosis was warranted by the constellation of skeletal abnormalities - mild platyspondyly, hypoplastic ilia, broad proximal femora with prominent lesser trochanters, mild brac...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s002470000401

    authors: Kamoda T,Nakajima R,Matsui A,Nishimura G

    更新日期:2001-02-01 00:00:00

  • Contemporary imaging in abdominal emergencies.

    abstract::Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-008-0863-4

    authors: Sivit CJ

    更新日期:2008-11-01 00:00:00

  • Angioplasty of renal transplant artery stenosis in children.

    abstract::Systemic hypertension after renal transplantation in children is frequent, occurring in 85% of the cases and may be the cause of severe neurologic complications. This can be due to multiple factors such as: rejection, recurrence of initial disease, steroid, etc. ... Among those factors, renal transplant artery stenosi...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02387633

    authors: Barth MO,Gagnadoux MF,Mareschal JL,Garel L,Mamou-Mani T,Brunelle FO

    更新日期:1989-01-01 00:00:00

  • In vivo MRI measurement of blood oxygen saturation in children with congenital heart disease.

    abstract:OBJECTIVE:The purpose of this prospective study was to measure in vivo blood oxygen saturation (%O2) by MRI in children with congenital heart disease (CHD) using population-based values for T2O (T2 signal decay of fully oxygenated blood) and K (a parameter representing the deoxyhemoglobin effect) and compare the %O2 wi...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-004-1305-6

    authors: Nield LE,Qi XL,Valsangiacomo ER,Macgowan CK,Wright GA,Hornberger LK,Yoo SJ

    更新日期:2005-02-01 00:00:00

  • Sinusitis and its imaging in the pediatric population.

    abstract::Imaging studies for sinusitis add little to the clinical management of the pediatric patient in most instances. The findings shown by paranasal sinus imaging are nonspecific and need to be correlated with clinical findings. Coronal CT is recommended for complications or for recurrent or persistent sinus disease. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s002470050251

    authors: Kronemer KA,McAlister WH

    更新日期:1997-11-01 00:00:00

  • A proposed radiological classification of childhood intra-thoracic tuberculosis.

    abstract::One of the obstacles in discussing childhood tuberculosis (TB) is the lack of standard descriptive terminology to classify the diverse spectrum of disease. Accurate disease classification is important, because the correct identification of the specific disease entity has definite prognostic significance. Accurate clas...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-004-1238-0

    authors: Marais BJ,Gie RP,Schaaf HS,Starke JR,Hesseling AC,Donald PR,Beyers N

    更新日期:2004-11-01 00:00:00

  • Ultrasound-guided musculoskeletal procedures in children.

    abstract::Ultrasound is an excellent tool to evaluate many pediatric musculoskeletal conditions. It may be used for both diagnosis and for guidance for therapeutic procedures. With US, the radiologist can readily evaluate the contralateral side for comparison. No sedation is typically required and ionizing radiation is avoided....

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-012-2599-4

    authors: Thapa M,Vo JN,Shiels WE 2nd

    更新日期:2013-03-01 00:00:00

  • Serial section-reconstruction of anomalous tracheobronchial branching patterns from CT scan images: bridging bronchus associated with sling left pulmonary artery.

    abstract::The use of the technique of wax-plate serial section-reconstruction, based on contiguous axial plane CT images of the upper thorax, to prepare a replica of the central air-way (trachea and major bronchi) of an infant with sling left pulmonary artery type 2B, with bridging bronchus, abortive right main bronchus, and tr...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02075204

    authors: Wells TR,Stanley P,Padua EM,Landing BH,Warburton D

    更新日期:1990-01-01 00:00:00

  • Unusual manifestations of Langerhans cell histiocytosis of the head and neck. Case report with pseudoaneurysm of external carotid artery, tracheal, mandibular, and sphenoid involvement.

    abstract::Langerhans cell histiocytosis of the head and neck is an uncommon histiocytic proliferative disorder that often clinically resembles an inflammatory process. A pseudoaneurysm of the external carotid artery was found by contrast-enhanced CT and confirmed by Doppler ultrasonography and angiography in a 9 year old girl w...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02020220

    authors: Herman TE,Shackelford GD,Borders JL,Dehner LP

    更新日期:1993-01-01 00:00:00

  • The key role of the pediatric radiologist in developing a multidisciplinary fetal center.

    abstract::With the demand for fetal imaging and fetal care programs on the rise, the authors of this manuscript review the components of building a successful fetal imaging center. Creating an environment that engages a multidisciplinary team, utilizing a central coordinator to review clinical and psychosocial aspects of each p...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-020-04702-4

    authors: Pesacreta LD,Cilli KE,Lawrence AK,Bulas DI

    更新日期:2020-12-01 00:00:00

  • Whole-body magnetic resonance imaging of pediatric cancer predisposition syndromes: special considerations, challenges and perspective.

    abstract::Cancer predisposition syndromes increase the incidence of tumors during childhood and are associated with significant morbidity and mortality. Imaging is paramount for ensuring early detection of neoplasms, impacting therapeutic interventions and potentially improving outcome. While conventional imaging techniques inv...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-019-04431-3

    authors: Saade-Lemus S,Degnan AJ,Acord MR,Srinivasan AS,Reid JR,Servaes SE,States LJ,Anupindi SA

    更新日期:2019-10-01 00:00:00

  • Long survival in thanatophoric dwarfism.

    abstract::A case of thanatophoric dwarfism living for 10 weeks with minimal supportive care is presented. Although early death is usual, survival for months is compatible with the diagnosis. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF00975319

    authors: Moir DH,Kozlowski K

    更新日期:1976-12-15 00:00:00

  • Age-related normal ranges for the Haller index in children.

    abstract:PURPOSE:The Haller index is an accepted CT method for evaluating thoracic dimensions in patients with pectus excavatum. The purpose of this study is to establish age- and gender-related norms for the Haller index in childhood. MATERIALS AND METHODS:We retrospectively reviewed 574 consecutive chest CT examinations (M=2...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-003-1116-1

    authors: Daunt SW,Cohen JH,Miller SF

    更新日期:2004-04-01 00:00:00

  • Frusemide-induced nephrocalcinosis in very low birth weight infants.

    abstract::Three very low birth weight infants, treated with frusemide for broncho-pulmonary dysplasia are described. They all developed medullary nephrocalcinosis identifiable by real time ultrasound. The sonographic findings of diffuse medullary hyper-echogenicity appears to be specific for nephrocalcinosis. ...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/BF02389002

    authors: Kenney IJ,Aiken CG,Lenney W

    更新日期:1988-01-01 00:00:00

  • A guide to the recognition of skeletal disorders in the fetus.

    abstract::The discovery of fetal skeletal abnormality on prenatal US mandates an extended study of the fetus. This extended examination includes specific views and measurements of the fetal skeleton. Lethality can be predicted if severe pulmonary hypoplasia is present. Specific diagnosis of a fetal osteochondrodysplasia is diff...

    journal_title:Pediatric radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00247-005-0087-9

    authors: Teele RL

    更新日期:2006-06-01 00:00:00

  • Sclerotic bone lesions at abdominal magnetic resonance imaging in children with tuberous sclerosis complex.

    abstract:BACKGROUND:Sclerotic bone lesions are often seen on chest CT in adults with tuberous sclerosis complex. OBJECTIVE:To characterize bone lesions at abdominal MRI in children with tuberous sclerosis complex. MATERIALS AND METHODS:This retrospective review included 70 children with tuberous sclerosis complex who had unde...

    journal_title:Pediatric radiology

    pub_type: 杂志文章

    doi:10.1007/s00247-016-3549-3

    authors: Boronat S,Barber I,Pargaonkar V,Chang J,Thiele EA

    更新日期:2016-05-01 00:00:00