A new ultrasound-guided technique for complex lumbar punctures

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Chinese anaesthetists report on their experience of performing complex lumbar punctures in two adults with spinal muscular atrophy being treated with nusinersen:

  • both patients, aged 26 and 35, had a complex spinal anatomy with Cobb angles measured at 90° and 83° respectively;
  • a new ultrasound-guided protocol, designed to overcome the limitations associated with needle angulation, was tested on each patient on eleven occasions,
  • the technique proved useful, resulting in a significant improvement in the success rate of lumbar punctures prior to nusinersen injection.

This protocol still needs to be tested on a larger number of patients and, however, appears to be highly operator-dependent.

Technical feasibility of an angle-free ultrasound-assisted approach for challenging lumbar puncture in complex spinal anatomy: a two-patient case series. Wang X, Luo Y, Zhang X, Lu X et al. BMC Anesthesiol. 2026 Jul 22.

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