Spanish clinicians report their experience with an unconventional injection route in the treatment of SMN1-related proximal spinal muscular atrophy (SMA) with nusinersen :
- six patients with SMA, including five with type II and one with type III, benefited from this treatment due to the impossibility of using the lumbar route,
- Five were over 18 years of age,
- The neurosurgical protocol involved a partial laminectomy of the C5-C6 vertebrae in order to insert an indwelling intrathecal catheter, connected to a small Ommaya-type reservoir placed under the skin in the mastoid region, close to the ear.
- the four-monthly injections of nusisernen were carried out subcutaneously, directly into the reservoir,
- the patients continued to improve clinically, and more significantly in their upper limbs.
According to the authors, this technique is interesting and not very dangerous, but should be reserved for the most complex cases of SMA.
