• Shuhei Machida, Masayuki Miyagi, Wataru Saito, Ayano Matsui, Takayuki Imura, Gen Inoue, Toshiyuki Nakazawa, Eiki Shirasawa, Shinsuke Ikeda, Ayumu Kawakubo, Akiyoshi Kuroda, Yuji Yokozeki, Yusuke Mimura, Kentaro Uchida, Tsutomu Akazawa, and Masashi Takaso.
• Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan.
• Spine Surg Relat Res. 2021 Jan 1; 5 (2): 109-113.

IntroductionSpinal muscular atrophy (SMA) is defined as a neuromuscular disorder induced by progressive weakness of the skeletal muscle and is usually accompanied by progressive spinal deformity including scoliosis. The newly developed Nusinersen, which is the first approved drug worldwide for SMA, requires accurate intrathecal injection, which is sometimes difficult in patients with severe spinal deformity.Technical NoteFor an accurate intrathecal approach in patients who have spinal fusion surgery to treat neuromuscular scoliosis, we have combined an L3 laminectomy with spinal correction and fusion surgery. Here, we review four cases of SMA in patients who underwent the additional L3 laminectomy during surgery to treat spinal scoliosis. A successful intrathecal approach was made using fluoroscopic guidance in all four patients, who were then administered with Nusinersen.ConclusionsOur findings show that additional lumbar laminectomy during surgery for spinal scoliosis has effectively allowed for intrathecal injection of Nusinersen.Copyright © 2021 by The Japanese Society for Spine Surgery and Related Research.

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