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Intrathecal baclofen therapy in children with severe spasticity: Outcome and complications

Matthias Walter1, Stefan Altermatt, Claudia Furrer

  • 1Neuro-Urology, Spinal Cord Injury Centre & Research, University of Zurich, Balgrist University Hospital , Zurich , Switzerland .

Developmental Neurorehabilitation
|August 28, 2013
PubMed

Insights

Intrathecal baclofen (ITB) therapy effectively reduces lower limb spasticity in children with congenital brain injuries. However, close patient monitoring is crucial due to a high incidence of complications, particularly early after implantation.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Severe spasticity in children with congenital brain injuries significantly impacts motor function and quality of life.
  • Intrathecal baclofen (ITB) therapy is a potential treatment option for refractory spasticity.

Purpose of the Study:

  • To evaluate the clinical effectiveness of ITB therapy in reducing spasticity in pediatric patients.
  • To determine the incidence and types of complications associated with ITB therapy in this population.

Main Methods:

  • Retrospective review of medical charts for 15 pediatric patients with congenital brain injuries.
  • Patients received ITB implantation for severe spasticity between 2003 and 2009.
  • Data analysis focused on changes in spasticity (Modified Ashworth Scale) and complication rates.

Main Results:

  • ITB therapy significantly decreased lower limb spasticity (p < 0.05) with increased baclofen dosage (p = 0.001).
  • A significant increase in Cobb angle was observed in patients with pre-existing scoliosis (p < 0.05).
  • Six patients (40%) experienced 10 complications (9 device-related, 1 accidental), primarily within three years post-implantation.

Conclusions:

  • Intrathecal baclofen is an effective treatment for reducing lower limb spasticity in pediatric patients.
  • The high rate of complications necessitates vigilant monitoring, especially during the early post-operative phase.
Abstract

Keywords:
Cerebral palsycongenital brain injurypaediatric

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