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Externalization of Intrathecal Baclofen Pumps Using a Shoulder Sling: Technique and Clinical Outcomes
Ahmed Abdelwahab1, Ariana Chacon, Hasna Loulida
1Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Operative Neurosurgery (Hagerstown, Md.)
|June 5, 2026
Summary
A new axillary shoulder sling technique for externalizing intrathecal baclofen (ITB) pumps offers a secure and comfortable option for managing infections. This method successfully resolved infections and allowed for pump reimplantation without complications.
Area of Science:
- Neurosurgery
- Medical Devices
- Infectious Disease Management
Background:
- Intrathecal baclofen (ITB) pumps are crucial for managing spasticity.
- Infections necessitate temporary ITB pump removal, posing challenges for continuous therapy.
- Traditional externalization methods can be uncomfortable and prone to complications.
Purpose of the Study:
- To introduce and evaluate a novel axillary shoulder-sling technique for externalizing ITB pumps.
- To assess the clinical outcomes of this technique in patients requiring temporary pump removal due to infection.
Main Methods:
- Retrospective review of 14 patients using the axillary sling technique for ITB pump externalization.
- Procedure involved tunneling a new catheter to the midaxillary line and securing the pump in a sterile sling under the armpit.
- Pumps were externalized for a median of 2 months with continuous baclofen infusion and weekly sling changes.
Main Results:
- The technique was successful in all patients, with no disconnections or infection recurrence.
- Continuous baclofen delivery was maintained, preventing spasticity exacerbation.
- Patients reported improved comfort, mobility, and psychological well-being compared to abdominal placements.
Conclusions:
- The axillary shoulder-sling technique provides a secure, comfortable, and effective method for temporary ITB pump externalization during infection management.
- This approach facilitates continuous baclofen infusion and infection resolution.
- Further prospective studies are warranted to validate this promising technique.
