A novel approach to prevent repeated catheter migration in a patient with a baclofen pump: a case report

We report a novel solution to a problem of repeated catheter migration that may aid others caring for patients with catheter migration problems. Catheter migration is a frequently reported complication of intrathecal drug delivery systems. We report on an ambulatory patient with a baclofen pump for control of spasticity due to cerebral palsy and dystonia; the patient suffered repeated episodes of catheter migration. The ultimate solution to the migrations was to place a pediatric pump in the lower thoracic, paraspinal region with the catheter entering the thoracic spine directly adjacent to the pump, thereby minimizing the differential motion between the pump and the spine, which was thought to be the cause of the repeated migration. This solution has not been previously described. Paraspinal pump placement may eliminate repeated catheter migration for patients with intrathecal drug pumps.