RT Journal Article SR Electronic T1 Transforaminal Lumbar Puncture: An Alternative Technique in Patients with Challenging Access JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 986 OP 991 DO 10.3174/ajnr.A5596 VO 39 IS 5 A1 D.R. Nascene A1 C. Ozutemiz A1 H. Estby A1 A.M. McKinney A1 J.B. Rykken YR 2018 UL http://www.ajnr.org/content/39/5/986.abstract AB SUMMARY: Interlaminar lumbar puncture and cervical puncture may not be ideal in all circumstances. Recently, we have used a transforaminal approach in selected situations. Between May 2016 and December 2017, twenty-six transforaminal lumbar punctures were performed in 9 patients (25 CT-guided, 1 fluoroscopy-guided). Seven had spinal muscular atrophy and were referred for intrathecal nusinersen administration. In 2, CT myelography was performed via transforaminal lumbar puncture. The lumbar posterior elements were completely fused in 8, and there was an overlying abscess in 1. The L1–2 level was used in 2; the L2–3 level, in 10; the L3–4 level, in 12; and the L4–5 level, in 2 procedures. Post-lumbar puncture headache was observed on 4 occasions, which resolved without blood patching. One patient felt heat and pain at the injection site that resolved spontaneously within hours. One patient had radicular pain that resolved with conservative treatment. Transforaminal lumbar puncture may become an effective alternative to classic interlaminar lumbar puncture or cervical puncture.LPlumbar punctureSMAspinal muscular atrophySMNsurvival motor neuronTFLPtransforaminal lumbar puncture