Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Mar 30;8(5):e00965.
doi: 10.1002/brb3.965. eCollection 2018 May.

Eleven Years' Experience With Intrathecal Baclofen - Complications, Risk Factors

Affiliations
Free PMC article
Observational Study

Eleven Years' Experience With Intrathecal Baclofen - Complications, Risk Factors

Elke Pucks-Faes et al. Brain Behav. .
Free PMC article

Abstract

Objective: Treatment with intrathecal baclofen (ITB) is commonly used in patients with severe spasticity. However, complications may occur after implantation of the ITB-device, albeit mainly procedure- and device-related problems. The aim of the study was to assess surgical- as well as catheter- and pump-related complications and define their risk factors.

Methods: We retrospectively evaluated all patients with an implanted ITB-device who were treated at the Department of Neurology, Hochzirl Hospital, Zirl, Austria, between 2006 and 2016.

Results: Twenty-nine of 116 (25%) patients experienced 32 complications: 5 procedure- and 27 device-related (4 pump- and 23 catheter-associated) problems occurred. Risk factors for sustaining any complication were a spinal localization of lesion (odds ratio [OR] OR 2.71, p = .021), other catheter types than an Ascenda® catheter (OR 3.87, p = .041), a lower modified Rankin Scale (median 4 vs. 5; OR 2.86, p = .015) and a higher Barthel Index (median 53 vs. 0; OR 2.84, p = .006). The median time from the last ITB-related surgery to the first complication was 18 (IQR 1-57) months. Overall, 47% complications occurred within the first year after any surgical procedure regarding the ITB-device, thereof 25% within the first month.

Conclusions: Procedure- and device-related complications are frequent after implantation of an ITB-device with catheter-associated complications as the most frequently encountered problems. Patients with a spinal origin of spasticity, a lower modified Rankin Scale and a higher Barthel Index have a higher risk to sustain a complication.

Keywords: autonomic nervous system diseases; baclofen; brain injuries; sympathetic nervous system; traumatic.

Figures

Figure 1
Figure 1
Temporal distribution of occurring complications within the first 7 years after the last intrathecal baclofen (ITB)‐related surgical procedure (first implantation surgery, replacement surgery due to end of battery life or due to a revision after a complication)
Figure 2
Figure 2
Temporal distribution of occurring complications within the first 12 months after the last surgical procedure (first implantation surgery, replacement surgery due to end of battery life or due to a revision after a complication)

Similar articles

See all similar articles

Cited by 1 article

References

    1. Albright A. L., Barron W. B., Fasick M. P., Polinko P., & Janosky J. (1993). Continuous intrathecal baclofen infusion for spasticity of cerebral origin. JAMA, 270, 2475–2477. https://doi.org/10.1001/jama.1993.03510200081036 - DOI - PubMed
    1. Albright A. L., Cervi A., & Singletary J. (1991). Intrathecal baclofen for spasticity in cerebral palsy. JAMA, 265, 1418–1422. https://doi.org/10.1001/jama.1991.03460110084029 - DOI - PubMed
    1. Armstrong R. W., Steinbok P., Cochrane D. D., Kube S. D., Fife S. E., & Farrell K. (1997). Intrathecally administered baclofen for treatment of children with spasticity of cerebral origin. Journal of Neurosurgery, 87, 409–414. https://doi.org/10.3171/jns.1997.87.3.0409 - DOI - PubMed
    1. Awaad Y., Rizk T., Siddiqui I., Roosen N., McIntosh K., & Waines G. M. (2012). Complications of intrathecal baclofen pump: Prevention and cure. ISRN Neurology, 2012, 575168. - PMC - PubMed
    1. Becker R., Alberti O., & Bauer B. L. (1997). Continuous intrathecal baclofen infusion in severe spasticity after traumatic or hypoxic brain injury. Journal of Neurology, 244, 160–166. https://doi.org/10.1007/s004150050067 - DOI - PubMed

Publication types

LinkOut - more resources

Feedback