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Adult Scoliosis Following Intrathecal Baclofen Therapy
Hiroshi Fujioka1,2, Hideki Harada3, Eiichirou Urasaki4
1Department of Neurosurgery, Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Fukuoka, JPN.
Cureus
|January 10, 2022
Summary
Intrathecal baclofen (ITB) therapy may pose a risk for developing scoliosis in adults. This case report highlights the importance of careful monitoring for spinal changes in patients undergoing ITB treatment.
Area of Science:
- Neurology
- Orthopedics
- Rehabilitation Medicine
Background:
- Intrathecal baclofen (ITB) therapy is effective for managing spasticity.
- A 56-year-old female with chronic hemiparesis received an ITB pump for spasticity control.
Observation:
- Postoperative lumbar pain emerged one year after ITB pump implantation.
- Undiagnosed scoliosis was identified two years postoperatively and progressed over five years.
- The patient experienced a significant walking disturbance due to scoliosis progression.
Findings:
- The patient developed progressive scoliosis following ITB therapy, with a Cobb angle increasing from 19 to 28 degrees.
- Removal of the ITB pump and subsequent spinal decompression surgery led to stabilization of scoliosis.
- Neurological condition and scoliosis progression stabilized after ITB pump removal.
Implications:
- This case suggests a potential link between ITB therapy and the development of adult scoliosis.
- Preoperative screening and vigilant postoperative surveillance are crucial for patients receiving ITB therapy.
- Alternative spasticity management, such as Botox injections, may be considered alongside spinal monitoring.
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