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Intrathecal baclofen therapy: complication avoidance and management.

Neil Haranhalli1, Dhanya Anand, Jeffrey H Wisoff

  • 1Department of Neurosurgery, Division of Pediatric Neurosurgery, NYU Langone Medical Center, New York, NY, USA.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|September 21, 2010
PubMed
Summary

Intrathecal baclofen (ITB) therapy for spasticity can lead to complications, many preventable with improved surgical techniques and patient selection. Careful management minimizes risks associated with this essential treatment.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Devices

Background:

  • Intrathecal baclofen (ITB) therapy is a recognized treatment for spasticity and dystonia.
  • Complications associated with ITB include mechanical failures, infections, cerebrospinal fluid leaks, and baclofen withdrawal or overdose.

Purpose of the Study:

  • To review institutional experience with ITB therapy.
  • To emphasize complication avoidance and share lessons learned from ITB treatment.

Main Methods:

  • Retrospective review of 87 patients treated with ITB therapy.
  • Analysis of surgical techniques, complication types, timing, treatment, and outcomes.

Main Results:

  • 17.1% of patients experienced 25 complications, with catheter fracture being most common.
  • Complications occurred a mean of 24.2 months post-implantation.
  • Improved surgical techniques and patient selection could have prevented over 50% of complications.

Conclusions:

  • ITB therapy is linked to complications requiring surgical intervention.
  • Adherence to strict surgical protocols and appropriate patient selection can prevent many ITB-related complications.