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


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.

鞘内注射巴氯芬泵治疗严重痉挛– 15年的经验


患者和方法:24例患者,中位年龄36(30 -51)岁,有脊髓损伤引起的严重、顽固性痉挛(13例)、多发性硬化(7例)等脑脊液病因学(4例)病史,行巴氯芬泵植入式手术。采用临床量表(Ashworth量表、痉挛频率量表、内收肌张力分级)对泵植入式巴氯芬有效剂量滴定前后的痉挛状态进行评估。使用Barthel指数评估巴氯芬泵植入前、植入后1年、植入后5年和植入后10年的功能疗效。

结果:在平均92个月(41 -136个月)的随访期间,未发现死亡病例。没有人因为巴氯芬泵的植入而出现任何新的神经损伤。所有患者均有统计学意义的痉挛改善和痉挛频率降低。我们根据植入泵后1年、5年和10年的Barthel指数记录了功能状态的显著改善。结论:鞘内注射巴氯芬泵是治疗顽固性痉挛的一种安全有效的方法,可通过增加日常生活活动的独立性来改善功能。



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


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