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Related Experiment Videos

Implanted pump systems for treatment of spasticity.

J Zierski1, H Müller, D Dralle

  • 1Department of Neurosurgery, Justus-Liebig-University, Giessen, Federal Republic of Germany.

Acta Neurochirurgica. Supplementum
|January 1, 1988
PubMed
Summary

Continuous intrathecal baclofen administration via a pump system effectively manages severe spasticity in patients unresponsive to oral medications. This treatment significantly reduces spasticity and improves quality of life without central side effects.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Severe spasticity significantly impairs rehabilitation in approximately one-third of patients with spinal trauma, multiple sclerosis, and brain injuries.
  • Traditional treatments for intractable spasticity include invasive surgical or destructive procedures.
  • Oral antispastic medications are often inadequate for managing severe spasticity.

Purpose of the Study:

  • To evaluate the efficacy and safety of continuous intrathecal baclofen administration using a totally implantable pump system for uncontrollable spasticity.
  • To assess the impact of this treatment on spasticity scores, electromyography, and quality of life.

Main Methods:

  • A study involving 30 patients with incapacitating spasticity resistant to oral baclofen treatment.

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  • Indications included spinal cord injury, multiple sclerosis, cerebral palsy, and brain injury.
  • Clinical assessment utilized spasticity scores, integrated electromyography (IEMG), and motography.

    • Main Results:

    • All patients achieved effective spasticity control with intrathecal baclofen.
    • Mean IEMG reduction was 55%, and Ashworth's score decreased from 3 to 0.
    • Significant improvements in quality of life were observed without impairment of voluntary motor function or central side effects.

    Conclusions:

    • Continuous intrathecal baclofen delivery via an implantable pump is a highly effective treatment for severe, refractory spasticity.
    • The mechanism involves direct spinal GABAergic action, bypassing systemic side effects.
    • Minor, correctable complications were associated with the pump system.