FIGURE 1.

SIC system. A, The interlocked intrathecal catheter and subcutaneous infusion port used to construct the hybrid nusinersen delivery system. B, Distortions of spinal and pulmonary anatomy, commonly observed among older SMA patients, that inspired design of the SIC system. C, The SIC system in situ, with the infusion port and intrathecal catheter tip marked by a yellow arrow and arrowhead, respectively. D, The SIC allows for safe, low-cost, repeated outpatient nusinersen dosing. SIC indicates subcutaneous intrathecal catheter; SMA, spinal muscular atrophy.