Related Experiment Video
Updated: Jul 20, 2026
07:47
Intrathecal Delivery of Antisense Oligonucleotides in the Rat Central Nervous System
Published on: October 29, 2019
Cervical catheter tip placement for intrathecal baclofen administration
Todd D McCall1, Joel D MacDonald
1Department of Neurosurgery, University of Utah, Salt Lake City 84106, USA.
Neurosurgery
|September 7, 2006
Summary
Cervical intrathecal baclofen catheter placement effectively reduces upper and lower extremity spasticity. This approach is safe and offers comparable spasticity control to thoracic placement, without increasing complications.
Area of Science:
- Neurosurgery
- Neurology
- Rehabilitation Medicine
Background:
- Intrathecal baclofen (ITB) infusion is a key treatment for severe spasticity.
- Traditional ITB catheter placement in the thoracic region can create a drug gradient.
- This gradient may limit efficacy in controlling upper extremity spasticity.
Purpose of the Study:
- To assess the feasibility, safety, and efficacy of cervical ITB catheter placement.
- To determine if rostral catheter placement improves upper extremity spasticity control.
Main Methods:
- Retrospective review of 48 patients with ITB pumps.
- Comparison of 23 patients with cervical catheter placement versus 25 with thoracic placement.
- Evaluation of complications and pre/postoperative Ashworth scores.
Main Results:
- Cervical catheter placement significantly reduced upper extremity spasticity (Ashworth scores decreased from 4.0 to 3.0, P = 0.003).
- Both cervical and thoracic placements effectively reduced lower extremity spasticity.
- Complications were similar between groups, with one case of aspiration pneumonia possibly linked to sedation.
Conclusions:
- Cervical ITB catheter placement is a safe and effective strategy.
- This approach provides balanced control of spasticity in both upper and lower extremities.
- Rostral catheter placement does not elevate complication risks associated with ITB therapy.
Related Concept Videos
01:29Drug Delivery: Parenteral Route
The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...