Intrathecal baclofen pump for the treatment of severe spasticity – 15 years of experience


Authors: S. Vaneková 1;  S. Tóth 1;  M. Melišek 2;  J. Vanko 2;  P. Harangozó 2;  B. Rudinský 2
Authors‘ workplace: Klinika fyziatrie, balneológie a liečebnej rehabilitácie FN s poliklinikou Nové Zámky, Slovensko 1;  Neurochirurgická klinika FN s poliklinikou Nové Zámky, Slovensko 2
Published in: Cesk Slov Neurol N 2019; 82(4): 430-436
Category: Original Paper
doi: 10.14735/amcsnn2019430

Overview

Aim: Severe spasticity as a result of the affected CNS is difficult to be influenced by standard therapies in a number of cases. In recent years, continuous administration of baclofen in the intrathecal space using a pump system has proven to be effective. In this paper, we evaluate our experience with baclofen pump implantation from the aspect of this method’s safety and efficacy.

Patients and methods: 24 patients, median age 36 (30 -51) years, with a history of severe, intractable spasticity due to spinal cord injury (13 cases), multiple sclerosis (7 cases) and other cerebrospinal aetiology (4 cases), who underwent baclofen pump implantation. Spasticity was assessed using clinical scales (Ashworth Scale, Spasm Frequency Scale, Adductor Tone Rating) before and after titrating the effective dose of baclofen after pump implantation. Functional benefits were evaluated with Barthel Index before, 1 year, 5 and 10 years after implantation of the baclofen pump.

Results: During a follow up period with a median of 92 (41 -136) months, no death was noted. Nobody suffered from any new neurological impairment as a result of baclofen pump implantation. All patients presented with statistically significant improvement of spasticity and reduction of spasm frequency. We documented statistically significant improvement in functional status according to the Barthel Index 1, 5 and 10 years after pump implantation.

Conclusion: Intrathecal baclofen pump infusion is a safe and very effective method of treatment for intractable spasticity, which leads to functional improvement by increasing independence in daily living activities.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.

Keywords:

spasticity – spinal cord injury – multiple sclerosis – intrathecal baclofen – baclofen pump


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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