This video describes a new procedure that provides safer and easier access for intrathecal injection of nusinersen in patients with spinal muscle atrophy. Nusinersen therapy changed the natural history of spinal muscle atrophy; however, until now, patients undergoing scoliosis surgery were excluded from nusinersen therapy because posterior fusion of the spine prevented access for intrathecal injection. These patients required a procedure to provide lumbar access for intrathecal injection.

The video details a single-center, single-surgeon case series of five patients (four females and one male; mean age, 11 years) who underwent laminotomy with fat grafting at L3-L4 to provide safer access for intrathecal injection of nusinersen. Three of the patients underwent posterior fusion of the spine before nusinersen therapy. Two of the patients underwent posterior fusion of the spine after nusinersen therapy.

The procedure described is simple and effectively provides safe access for intrathecal administration of nusinersen in patients undergoing scoliosis surgery.