Intrathecal baclofen therapy over 10 years

Intrathecal baclofen (ITB) therapy has evolved into a standard treatment for severe spasticity. After this therapy had been provided for 10 years, a retrospective chart review on 50 patients, representing a total 2,922 patient months of ITB service, was done. These patients suffered severe spasticity from a number of disease processes including multiple sclerosis, cerebral palsy, and brain injury. The average dosage for the total group was 463 micrograms per day (microg/day), and 32% used a simple infusion mode. Pump refills occurred every 3 months for 58% of the group. Three evolving trends in ITB therapy were identified from clinical trial to current management: (a) higher catheter tip placement, (b) use of more complex infusion modes, and (c) a decreased complication rate.